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MS. SUSAN LESLIE DAVIS CHP

>> Community Health Worker >> Other Service Providers

Registrant NPI Number: 1881847556

Individual Registrant:
MS. SUSAN LESLIE DAVIS CHP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
172 MAIN STREET  SAND POINT, AK 99661-0172 US
Tel: 907-383-3151  Fax: 907-383-5688

Contact information for business:
3380 C ST STE 100  ANCHORAGE, AK 99503-3949 US
Tel: 907-277-1440  Fax: 907-277-1446

Registration Information:
NPI: 1881847556
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y172V00000XOther Service Providers
Community Health Worker
AK08-983-P

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
SPECIALIST174400000XAK01




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