Healthcare Provider Details

I. General information

NPI: 1831476118
Provider Name (Legal Business Name): ASHLEY KOBYLINSKI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ASHLEY MCMULLEN PHARMD

II. Dates (important events)

Enumeration Date: 11/14/2011
Last Update Date: 06/03/2021
Certification Date: 06/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4353 LAKE OTIS PKWY
ANCHORAGE AK
99508-5216
US

IV. Provider business mailing address

4353 LAKE OTIS PKWY
ANCHORAGE AK
99508-5216
US

V. Phone/Fax

Practice location:
  • Phone: 907-561-2005
  • Fax:
Mailing address:
  • Phone: 815-257-8272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051-294954
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHAP2069
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: