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JACKI JOHNSON CHA

>> Community Health Worker >> Other Service Providers

Registrant NPI Number: 1003203092

Individual Registrant:
 JACKI  JOHNSON CHA
Gender: F
Not Sole Proprietor

Location and contact information for practice:
189 AIRPORT ROAD  UNALAKLEET, AK 99684 US
Tel: 907-624-3535  Fax: 907-624-3692

Contact information for business:
50 SCHOOL BLVD  STEBBINS, AK 99671 US
Tel: 907-934-3311  Fax: 907-934-3312

Registration Information:
NPI: 1003203092
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y172V00000XOther Service Providers
Community Health Worker

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
CHACHA-IIAK01




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