institution
Legacy Health Clinic, Llc
Family Nurse Practitioner in Ketchikan, Alaska
NPI 1942670005

Legacy Health Clinic, Llc is a Family Nurse Practitioner based in Ketchikan, AK and is specialized in Family. Legacy Health Clinic, Llc practices in Ketchikan, AK. The NPI Number for Legacy Health Clinic, Llc is 1942670005 and holds a License No. 1106 (Alaska).

The current practice location address for Legacy Health Clinic, Llc is 3524 Tongass Ave, Ketchikan, AK and can be reached out via phone at 907-225-6355. You can also correspond with Legacy Health Clinic, Llc through the mailing address at 3524 TONGASS AVE, KETCHIKAN, AK - 99901-5635 (mailing address contact number: 907-225-6355).

Location: 3524 Tongass Ave, Ketchikan, AK, 99901-5635
institution
Provider Profile Details
NPI Number
1942670005
Provider Name
Legacy Health Clinic, Llc
Credential
Provider Entity Type
Organization
Address
3524 Tongass Ave, Ketchikan, AK, 99901-5635
Phone Number
907-225-6355
Fax Number
Provider Enumeration Date
10/01/2015
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1580081 05 AK
1022301 05 AK
institution
Provider Business Practice Location Address Details
Address
3524 Tongass Ave
City
State
Zip
99901-5635
Phone Number
907-225-6355
Fax Number
person
Provider Business Mailing Address Details
Address
3524 Tongass Ave
City
State
Zip
99901-5635
Phone Number
907-225-6355
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
License No.
551 (Alaska)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
1106 (Alaska)
Definition
Definition to come...
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