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GWENDOLYN EVAN

>> Community Health Worker >> Other Service Providers

Registrant NPI Number: 1356756217

Individual Registrant:
 GWENDOLYN  EVAN 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
23 MAIN WAY  KONGIGANAK, AK 99545 US
Tel: 907-557-5127  Fax: --

Contact information for business:
PO BOX 5089  KONGIGANAK, AK 99545 US
Tel: --  Fax: --

Registration Information:
NPI: 1356756217
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y172V00000XOther Service Providers
Community Health Worker

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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