Doctor Name: | KELANI SHANER |
NPI Number: | 1316396302 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 104003 |
Business Practice Address: | 300 N Main St Wasilla, AK - 996547017 |
Business Phone Number: | 9073768020 |
Business Fax Number: | |
Mailing Address: | Po Box 879674, WASILLA |
State: | AK |
Postal Code: | 996879674 |
Phone Number: | 9073120940 |
Fax Number: | |
NPI Enumeration Date: | 06/09/2016 |
NPI Last Update Date: | 06/09/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 104003 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AK |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |