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NPI Code Detail

MEDICARE: BRENTON HILL

MEDICARE: BRENTON HILL
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
1163W00000XRegistered Nurse238164AK

General Provider Information

NPI Number : 1972456762
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENTON HILL
Provider Business Mailing Address
First Line : PO BOX 2715
Second Line :
City : PALMER
State : AK
Zip : 99645-2715
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 26731 W POINT MACKENZIE RD
Second Line :
City : WASILLA
State : AK
Zip : 99623-8709
Country : US
Telephone Number : 907-376-4534
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2026
Last Update Date : 02/19/2026

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Directions to “ BRENTON HILL ” Practice Location

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