Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 470 | AK |
NPI | 1003918426 |
---|---|
Provider Name | Sandra Frenier |
First Address | Anchorage, AK 99508-4616 |
Second Address | Anchorage, AK 99508-4616 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
NP0470 | (05) | AK |