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NPI Code Detail

MEDICARE: MR. CAROL LYNN KLAMSER ANP-C

MEDICARE: MR. CAROL LYNN KLAMSER ANP-C
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
1363LF0000XFamily Nurse Practitioner404AK

General Provider Information

NPI Number : 1871599126
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CAROL LYNN KLAMSER ANP-C
Provider Business Mailing Address
First Line : 4201 BARTLETT, STE. 201
Second Line :
City : HOMER
State : AK
Zip : 99603
Country : US
Telephone Number : 907-235-0310
Fax Number : 907-235-0276
Provider Business Practice Location Address
First Line : 4141 PENNOCK ST
Second Line :
City : HOMER
State : AK
Zip : 99603-7223
Country : US
Telephone Number : 907-226-2228
Fax Number : 907-226-2230
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 02/28/2020

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