Provider Demographics
NPI:1043982317
Name:FOLK, LEVI BRENNON
Entity Type:Individual
Prefix:
First Name:LEVI
Middle Name:BRENNON
Last Name:FOLK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 S CHUGACH ST
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-6795
Mailing Address - Country:US
Mailing Address - Phone:907-745-4920
Mailing Address - Fax:
Practice Address - Street 1:5851 E MAYFLOWER CT
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7881
Practice Address - Country:US
Practice Address - Phone:907-745-4920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator