| NPI | 1346601457 |
|---|---|
| Other Name | STATE OF ALASKA |
| Entity Type | Organization |
| Authorized Contact | SUSAN RENEE BERGMANN Nurse Manager 907-225-4350 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X (Licence: AK NURR8365) |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2016-03-16 |