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Annelle Glee Maygren

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NPI Number Detailed Information

Provider Information:

Name: Annelle Glee Maygren
Gender: F
Provider License Number If Given: 297

NPI Information:

NPI: 1477556488
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 1/18/2013

Provider Business Mailing Address:

Address: PO BOX 89
Klawock, AK 99925
Phone Number: 9077554967
Fax Number: 9077552414

Provider Business Practice Location Address:

Address: 6488 KLAWOCK HOLLIS HWY #4
Klawock, AK 99925
Phone Number: 9077554967
Fax Number: 9077552414

Provider Taxonomy:

Primary: 152W00000X
Secondary (if any): 152W00000X
State: AK