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TANIA R MCMULLEN CHA II-C

>> Community Health Worker >> Other Service Providers

Registrant NPI Number: 1700016128

Individual Registrant:
 TANIA R MCMULLEN CHA II-C
Gender: F
Not Sole Proprietor

Location and contact information for practice:
5530 MAIN STREET  PORT GRAHAM, AK 99603-5530 US
Tel: 907-284-2241  Fax: 907-284-2277

Contact information for business:
P.O. BOX 5530  PORT GRAHAM, AK 99603-5530 US
Tel: 907-284-2241  Fax: 907-284-2277

Registration Information:
NPI: 1700016128
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y172V00000XOther Service Providers
Community Health Worker
AK

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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