MEDICARE: LAKEVIEW FAMILY PRACTICE, LLC

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
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1356068480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAKEVIEW FAMILY PRACTICE, LLC

Provider Business Mailing Address
First Line	:	1901 N HEMMER RD APT 208
Second Line	:
City	:	PALMER
State	:	AK
Zip	:	99645-9673
Country	:	US
Telephone Number	:	907-745-3770
Fax Number	:

Provider Business Practice Location Address
First Line	:	1901 N HEMMER RD APT 208
Second Line	:
City	:	PALMER
State	:	AK
Zip	:	99645-9673
Country	:	US
Telephone Number	:	907-203-4677
Fax Number	:	800-516-0397

Authorized Official
Title or Position	:	FAMILY NURSE PRACTITIONER
Name	:	KIMBERLY J CRANDALL
Credential	:	APRN-FNP-BC
Telephone Number	:	907-982-7470

Provider Enumeration Date	:	10/19/2022
Last Update Date	:	07/15/2025

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Directions to “LAKEVIEW FAMILY PRACTICE, LLC ” Practice Location

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