MEDICARE: GLENDA EFETI BRILEY

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	376G00000X	Nursing Home Administrator		AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720432396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLENDA EFETI BRILEY

Provider Business Mailing Address
First Line	:	10178 VOYAGER CIR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99515-2240
Country	:	US
Telephone Number	:	907-201-0403
Fax Number	:

Provider Business Practice Location Address
First Line	:	10178 VOYAGER CIR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99515-2240
Country	:	US
Telephone Number	:	907-201-0403
Fax Number	:

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

Provider Enumeration Date	:	04/19/2016
Last Update Date	:	03/04/2025

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Directions to “ GLENDA EFETI BRILEY ” Practice Location

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