Individual
JACKI JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CHA
Contact information
Practice address
189 AIRPORT ROAD, UNALAKLEET, AK 99684
(907) 624-3535
(907) 624-3692
Mailing address
50 SCHOOL BLVD, STEBBINS, AK 99671
(907) 934-3311
(907) 934-3312
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CHA-II
CHA
AK
Enumeration date
04/17/2015
Last updated
12/08/2016
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