| NPI | 1679139596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYFANAE BRINKE Family Nurse Practitioner 907-315-4042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2021-02-01 |