Kathleen Wallace
Individual provider Active NPI Case Manager/Care Coordinator · Ninilchik, AK
NPI 1669877957 · NPPES record last updated Oct 29, 2014
Key facts
- NPI
- 1669877957
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 11845 Sterling Hwy
Ninilchik, AK 99639-9769 - Phone
- (907) 567-3990
- Fax
- (907) 567-3990
- NPI assigned
- Oct 29, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | AK | Yes |
Addresses
Primary practice location
11845 Sterling Hwy
Ninilchik, AK 99639-9769
Mailing address
11845 Sterling Hwy
Ninilchik, AK 99639-9769
Phone (907) 567-3990
Other providers in Ninilchik, AK
- Michelle Shepard
- Sarah C Spencer
- Elizabeth Marie Spofford
- Robert Stark
- Stormy Walkoff
- Carrie Ann Warren
- Catherine Pilibos West
- Zestivinal Zoubek
All providers in Ninilchik, AK · Case Manager/Care Coordinator in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.