Doctor Name: | MRS. CHRISTIE BENTZ |
NPI Number: | 1003285222 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 102586 |
Business Practice Address: | 3027 Mountainwood Cir Juneau, AK - 998019624 |
Business Phone Number: | 8025586758 |
Business Fax Number: | |
Mailing Address: | 3027 Mountainwood Cir, JUNEAU |
State: | AK |
Postal Code: | 998019624 |
Phone Number: | 8025586758 |
Fax Number: | |
NPI Enumeration Date: | 09/17/2015 |
NPI Last Update Date: | 09/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | 102586 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AK |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |