Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 5655094-4405 | UT |
NPI | 1013007640 |
---|---|
Provider Name | Janet A Bloch |
First Address | Anchorage, AK 99508-4627 |
Second Address | Anchorage, AK 99508-4627 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 02/05/2011 |