# COPPER RIVER NATIVE ASSOCIATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386333599
- **Authorized official:** NIKKI R WIEDLUND (SENIOR PATIENT FINANCIAL SERVICES)
- **Authorized official phone:** (907) 206-6812

## Contact information

- **Practice address:** MILE 111.5 RICHARDSON HWY, COPPER CENTER, AK 99573
- **Practice address phone:** (907) 822-5241
- **Mailing address:** PO BOX 383, GLENNALLEN, AK 99588-0383
- **Mailing address phone:** (907) 822-8841

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | NULL | Yes |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/03/2023
- **Last updated:** 05/03/2023