Grandpre, Clarice
Grandpre, Clarice is an sole proprietor health care provider with primary practice located at 995 Ellesmere Dr , Fairbanks AK 99709-5759. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Grandpre, Clarice can be contacted via phone (907) 479-8101.Contact Information
Primary practice address
995 Ellesmere Dr
Fairbanks AK 99709-5759
Phone: (907) 479-8101
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 2983 | Alaska |
Profile Details
| NPI number | 1679548002 |
|---|---|
| LBN Legal business name | Grandpre, Clarice |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 20th, 2006 |
| Last updated | Aug 28th, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679548002 | NPPES |
| Alaska | MEDICAID | MD0102 |
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