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General NPI Number Information
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NPI Number | 1063833937
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Entity Type | Organization
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Legal Business Name | UPSTREAM FAMILY MEDICINE INC
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Dates
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Enumeration Date | 12/19/2013
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 35743 KENAI SPUR HWY STE A
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City | SOLDOTNA
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State | AK
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Zip | 99669-7161
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Country | US
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Telephone | 907-260-4468
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Fax | 907-260-4467
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Provider Business Mailing Address
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Address Line | PO BOX 22652
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City | BELFAST
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State | ME
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Zip | 04915-4477
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Country | US
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Telephone | 907-260-4468
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Fax | 907-260-4467
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Authorized Official
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Title or Position | OWNER
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Name | DR. KRISTEN MARIE IAGULLI LEE
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Credential | MD
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Telephone | 907-260-4468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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