Healthcare Provider Details

I. General information

NPI: 1720432396
Provider Name (Legal Business Name): GLENDA EFETI BRILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2016
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10178 VOYAGER CIR
ANCHORAGE AK
99515-2240
US

IV. Provider business mailing address

10178 VOYAGER CIR
ANCHORAGE AK
99515-2240
US

V. Phone/Fax

Practice location:
  • Phone: 907-201-0403
  • Fax:
Mailing address:
  • Phone: 907-201-0403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License Number
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: