Lorraine Fullbright

Individual provider Active NPI Case Manager/Care Coordinator · Chugiak, AK

NPI 1902020290 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1902020290
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
License
CM6474 (AK)
Practice address
18606 Old Glenn Highway
Chugiak, AK 99567
Phone
(907) 688-0282
NPI assigned
Apr 11, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CM6474AKMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Family Outreach Center for Understanding Special Needs Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X CM6474 AK Yes

Addresses

Primary practice location

18606 Old Glenn Highway
Chugiak, AK 99567

Mailing address

PO Box 671750
Chugiak, AK 99567-1750

Other identifiers

IdentifierTypeStateIssuer
CM6474MedicaidAK

Other providers in Chugiak, AK

All providers in Chugiak, AK · Case Manager/Care Coordinator in Alaska

Sources for this page

Verify at the official NPI Registry.