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RENA JENNIFER BOOSHU CHP

>> Community Health Worker >> Other Service Providers

Registrant NPI Number: 1295098291

Individual Registrant:
 RENA JENNIFER BOOSHU CHP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
306 WEST 5TH AVENUE  NOME, AK 99762 US
Tel: 907-443-3311  Fax: 907-443-3471

Contact information for business:
306 WEST 5TH AVENUE  NOME, AK 99762 US
Tel: 907-443-3311  Fax: 907-443-3471

Registration Information:
NPI: 1295098291
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y172V00000XOther Service Providers
Community Health Worker
AK05-705-P

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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