Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | 361 | AK |
Y | 363L00000X | Nurse Practitioner | NURU361 | AK |
NPI | 1003972043 |
---|---|
Provider Name | Miss Katherine M Becher |
First Address | Soldotna, AK 99669-6999 |
Second Address | Soldotna, AK 99669-6999 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 13/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1022748 | (05) | AK |
361 | LICENSE (01) | AK |
MB0210182 | DEA (01) | AK |