Healthcare Provider Details

I. General information

NPI: 1730437427
Provider Name (Legal Business Name): APRIL LYNN FIESTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2012
Last Update Date: 08/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CAPE SARICHEF BLDG N46 USCG HSWL ROCKMORE KING CLINIC
KODIAK AK
99619
US

IV. Provider business mailing address

CAPE SARICHEF BLDG N46 USCG HSWL ROCKMORE KING CLINIC
KODIAK AK
99619
US

V. Phone/Fax

Practice location:
  • Phone: 907-487-5757
  • Fax:
Mailing address:
  • Phone: 907-487-5757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: