MEDICARE: ELLEN KATHY LOSCH-ROWE ANP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner	915	AK

General Provider Information

NPI Number	:	1396783734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLEN KATHY LOSCH-ROWE ANP

Provider Business Mailing Address
First Line	:	7021 HOWARD AVE
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99504-1899
Country	:	US
Telephone Number	:	907-332-0291
Fax Number	:	907-332-0291

Provider Business Practice Location Address
First Line	:	4001 LAKE OTIS PKWY
Second Line	:	SUITE 101
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5200
Country	:	US
Telephone Number	:	907-770-9710
Fax Number	:	907-565-7529

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	01/15/2008

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