| Kenai Family Practice Llc | |
|
135 Bidarka St Suite 101 Kenai AK 99611-7741 | |
| (907) 335-0034 | |
| (907) 335-0064 |
| Full Name | Kenai Family Practice Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 135 Bidarka St, Kenai, Alaska |
| Authorized Official Name and Position | Terri L Elliott (OWNER) |
| Authorized Official Contact | 9073350034 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenai Family Practice Llc 135 Bidarka St Suite 101 Kenai AK 99611-7741 Ph: (907) 335-0034 | Kenai Family Practice Llc 135 Bidarka St Suite 101 Kenai AK 99611-7741 Ph: (907) 335-0034 |
| NPI Number | 1255528733 |
|---|---|
| Provider Enumeration Date | 09/28/2007 |
| Last Update Date | 06/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255528733 | NPI | - | NPPES |
| K152261 | Other | AK | MEDICARE GROUP LEGACY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4040 (Alaska) | Primary |
| 363A00000X | Physician Assistant | 725 (Alaska) | Secondary |
| 363L00000X | Nurse Practitioner | 175 (Alaska) | Secondary |
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› Verified 9 days ago
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