Provider Demographics
NPI:1467341669
Name:PLATINUM MEDICAL CLUB
Entity type:Organization
Organization Name:PLATINUM MEDICAL CLUB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:907-600-5272
Mailing Address - Street 1:401 E 36TH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-4135
Mailing Address - Country:US
Mailing Address - Phone:907-600-5272
Mailing Address - Fax:907-885-6623
Practice Address - Street 1:401 E 36TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4135
Practice Address - Country:US
Practice Address - Phone:907-600-5272
Practice Address - Fax:907-885-6623
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NURSE PRACTITIONER FOR YOU PATIENT EDUCATION LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty