Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 128333 | AK |
N | 363LP2300X | Nurse Practitioner - Primary Care | 128333 | AK |
NPI | 1053505206 |
---|---|
Provider Name | Mrs. Henrietta Emokidi |
First Address | Anchorage, AK 99514-0665 |
Second Address | Anchorage, AK 99507-1166 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2007 |
Last Update Date | 10/09/2021 |