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RENEE M OLANNA CHA III

>> Community Health Worker >> Other Service Providers

Registrant NPI Number: 1619244340

Individual Registrant:
 RENEE M OLANNA CHA III
Gender: F
Not Sole Proprietor

Location and contact information for practice:
85058 CLARENCE ROAD  BREVIG MISSION, AK 99785-8505 US
Tel: 907-642-4311  Fax: 907-642-2216

Contact information for business:
85058 CLARENCE ROAD BOX 85058 BREVIG MISSION, AK 99785-8505 US
Tel: 907-642-4311  Fax: 907-642-2216

Registration Information:
NPI: 1619244340
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y172V00000XOther Service Providers
Community Health Worker
AK11-1153-III

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
11-1153-IIICHA IIIAK01




HEALTH CARE JOBS AK - Page 1



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