Provider Demographics
NPI:1528470416
Name:STIMSON, KATRINA (CARE COORDINATOR)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:STIMSON
Suffix:
Gender:F
Credentials:CARE COORDINATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6177 E MOUNTAIN HEATHER RD STE 105
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-8428
Mailing Address - Country:US
Mailing Address - Phone:907-707-1087
Mailing Address - Fax:907-707-1013
Practice Address - Street 1:6177 E MOUNTAIN HEATHER RD STE 105
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-8428
Practice Address - Country:US
Practice Address - Phone:907-707-1087
Practice Address - Fax:907-707-1013
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator