Healthcare Provider Details

I. General information

NPI: 1326810631
Provider Name (Legal Business Name): KIMBERLY MAIRE CALL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2023
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 RAILWAY AVE
SEWARD AK
99664-0999
US

IV. Provider business mailing address

302 RAILWAY AVE
SEWARD AK
99664-0999
US

V. Phone/Fax

Practice location:
  • Phone: 907-422-7921
  • Fax:
Mailing address:
  • Phone: 907-422-7921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: