Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 101807 | AK |
NPI | 1063945178 |
---|---|
Provider Name | Sherry Hilton |
First Address | Fairbanks, AK 99701-4961 |
Second Address | Fairbanks, AK 99701-4961 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2017 |
Last Update Date | 05/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101807 | STATE LICENSE NUMBER (01) | AK |