Provider Demographics
NPI:1184150724
Name:HOIBAKK, AUTUMN (RNFA)
Entity type:Individual
Prefix:
First Name:AUTUMN
Middle Name:
Last Name:HOIBAKK
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8215 KRONOS DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-4629
Mailing Address - Country:US
Mailing Address - Phone:907-632-2138
Mailing Address - Fax:
Practice Address - Street 1:8215 KRONOS DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502-4629
Practice Address - Country:US
Practice Address - Phone:907-632-2138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK31087163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant