Bacon, Kristin M

Bacon, Kristin M is an individual health care provider with primary practice located at 12801 Jeanne Rd , Anchorage AK 99516-3347. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Bacon, Kristin M can be contacted via phone (907) 230-0402.

Contact Information

Primary practice address
12801 Jeanne Rd Anchorage AK 99516-3347
Phone: (907) 230-0402
Fax: (907) 770-5755
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 2251P0200X 1159 Alaska

Profile Details

NPI number 1679618144
LBN Legal business name Bacon, Kristin M
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679618144 NPPES
Alaska MEDICAID PT9331
Alaska Other 419964

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