| NPI | 1356068480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY J CRANDALL Family Nurse Practitioner 907-982-7470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2022-10-19 |
| Last Update Date | 2025-07-15 |