Provider Demographics
NPI:1831360130
Name:KAREN DECKER-BROWN
Entity type:Organization
Organization Name:KAREN DECKER-BROWN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE PROPIETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:DECKER-BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:RN,ANP
Authorized Official - Phone:907-522-2626
Mailing Address - Street 1:11901 INDUSTRY WAY
Mailing Address - Street 2:SUITE 7A
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-3582
Mailing Address - Country:US
Mailing Address - Phone:907-522-2626
Mailing Address - Fax:907-522-2624
Practice Address - Street 1:11901 INDUSTRY WAY
Practice Address - Street 2:SUITE 7A
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-3582
Practice Address - Country:US
Practice Address - Phone:907-522-2626
Practice Address - Fax:907-522-2624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK847261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care