| Organization Name: | ALPINE DERMATOLOGY, LLC |
| NPI Number: | 1053619098 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KRIS J MILLER (PHYSICIAN ASSISTANT CERTIFIED) |
| Mailing Address: | 3225 Hospital Dr Unit 101a Juneau |
| State: | AK US |
| Postal Code: | 998017863 |
| Phone Number: | 9075235411 |
| Fax Number: | 9075239884 |
| NPI Enumeration Date: | 02/28/2011 |
| NPI Last Update Date: | 04/12/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 944 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |