Healthcare Provider Details

I. General information

NPI: 1003198151
Provider Name (Legal Business Name): KRISTEN LEWIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2011
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 ABBOTT RD
ANCHORAGE AK
99507-4456
US

IV. Provider business mailing address

2300 ABBOTT RD
ANCHORAGE AK
99507-4456
US

V. Phone/Fax

Practice location:
  • Phone: 907-365-2033
  • Fax:
Mailing address:
  • Phone: 907-365-2033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number170391
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number18132
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: