| NPI | 1558113225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA MORAN Director Of Patient Claims 907-982-8674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2024-04-04 |
| Last Update Date | 2025-01-24 |