Provider Demographics
NPI:1154446623
Name:MRAZ, KATE M (MS)
Entity Type:Individual
Prefix:MRS
First Name:KATE
Middle Name:M
Last Name:MRAZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:MRAZ
Other - Last Name:HANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:6854 TOWN AND COUNTRY PLACE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-2844
Mailing Address - Country:US
Mailing Address - Phone:907-230-4064
Mailing Address - Fax:888-519-4159
Practice Address - Street 1:6854 TOWN AND COUNTRY PLACE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502-2844
Practice Address - Country:US
Practice Address - Phone:907-230-4064
Practice Address - Fax:888-519-4159
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCM1251Medicaid