| NPI | 1073847943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA EBELACKER Owner 907-632-7577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: AK 435) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: AK 435) |
| Enumeration Date | 2009-09-25 |
| Last Update Date | 2009-11-23 |