MEDICARE: MRS. LOUISE COUTS KRESSLY ANP, MSN, MBA

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	363LA2200X	Adult Health Nurse Practitioner	209.016065	IL
2	363LA2200X	Adult Health Nurse Practitioner	NP360	AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	041.453459	OTHER	IL	ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
2	209.016065	OTHER	IL	ILLINOS DEPARTMENT OF FINANCIAL AND PROGESSIONAL REGULATION

General Provider Information

NPI Number	:	1639176225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LOUISE COUTS KRESSLY ANP, MSN, MBA

Provider Business Mailing Address
First Line	:	4251 WARWICK DR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5162
Country	:	US
Telephone Number	:	907-227-4924
Fax Number	:

Provider Business Practice Location Address
First Line	:	4251 WARWICK DR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5162
Country	:	US
Telephone Number	:	907-227-9432
Fax Number	:

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

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	07/21/2022

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