| NPI | 1205634649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN RENEE HATHCOAT Nurse Practitioner 907-440-2987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2025-03-03 |
| Last Update Date | 2025-03-03 |