| NPI | 1639536394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY LORRAINE EARNEST Owner/Fnp 907-617-5453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AK 1383) |
| Enumeration Date | 2016-01-25 |
| Last Update Date | 2016-01-25 |