| NPI | 1053883595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLI RAYE BROCK Advanced Nurse Practitioner, Busine 907-373-3335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 363LW0102X Nurse Practitioner, Women's Health | |
| Enumeration Date | 2018-12-21 |
| Last Update Date | 2018-12-21 |