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BERTHA BARR CHA
>> Community Health Worker >> Other Service ProvidersRegistrant NPI Number: 1932594108
Individual Registrant: BERTHA BARR CHA
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
85058 CLARENCE RD BREVIG MISSION, AK 99785 US
Tel: 907-642-4311 Fax: 907-642-2216
Tel: 907-642-4311 Fax: 907-642-2216
Contact information for business:
85058 CLARENCE RD BREVIG MISSION, AK 99785 US
Tel: 907-642-4311 Fax: 907-642-2216
Tel: 907-642-4311 Fax: 907-642-2216
Registration Information:
NPI: 1932594108
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 172V00000X | Other Service Providers Community Health Worker | AK | 14-1291-II |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| CHA II | 141291-II | AK | 01 |
