| Lakeview Family Practice, Llc | |
|
1901 N Hemmer Rd Ste 211 Palmer AK 99645-9690 | |
| (907) 203-4677 | |
| (907) 745-3780 |
| Full Name | Lakeview Family Practice, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1901 N Hemmer Rd Ste 211, Palmer, Alaska |
| Authorized Official Name and Position | Kimberly J Crandall (FAMILY NURSE PRACTITIONER) |
| Authorized Official Contact | 9079827470 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeview Family Practice, Llc 1901 N Hemmer Rd Ste 211 Palmer AK 99645-9690 Ph: (907) 745-3770 | Lakeview Family Practice, Llc 1901 N Hemmer Rd Ste 211 Palmer AK 99645-9690 Ph: (907) 203-4677 |
| NPI Number | 1356068480 |
|---|---|
| Provider Enumeration Date | 10/19/2022 |
| Last Update Date | 12/05/2022 |
| Medicare PECOS PAC ID | 5496110546 |
|---|---|
| Medicare Enrollment ID | O20230425002659 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356068480 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Kimberly Crandall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275277238 PECOS PAC ID: 6305201450 Enrollment ID: I20230425002746 |
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