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NPI Code Detail

MEDICARE: PATRICIA KJELLSEN

MEDICARE: PATRICIA KJELLSEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care CoordinatorAK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1171M00000XOTHERAKTAXONOMY NUMBER

General Provider Information

NPI Number : 1295858272
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA KJELLSEN
Provider Business Mailing Address
First Line : 2211 ARCA DR
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-3462
Country : US
Telephone Number : 907-277-6677
Fax Number : 907-272-2162
Provider Business Practice Location Address
First Line : 2211 ARCA DR
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-3462
Country : US
Telephone Number : 907-277-6677
Fax Number : 907-272-2162
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2007
Last Update Date : 07/08/2007

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Directions to “ PATRICIA KJELLSEN ” Practice Location

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