Provider Demographics
NPI:1699780114
Name:KROZEL, VALERIE K (MD)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:K
Last Name:KROZEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 E BOGARD RD STE 233
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7185
Mailing Address - Country:US
Mailing Address - Phone:907-352-1300
Mailing Address - Fax:907-352-1310
Practice Address - Street 1:950 E BOGARD RD STE 233
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7185
Practice Address - Country:US
Practice Address - Phone:907-352-1300
Practice Address - Fax:907-352-1310
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK4770207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD44093Medicaid
AK164110Medicare PIN
AKMD44093Medicaid