Individual
MS. SUMMER ANN MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CHA II
Contact information
Practice address
100 SLOCUM DRIVE, KING COVE, AK 99612
(907) 497-2311
(907) 497-2310
Mailing address
3380 C ST STE 100, ANCHORAGE, AK 99503-3949
(907) 497-2311
(907) 497-2310
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CL9107
—
AK
Enumeration date
08/13/2010
Last updated
12/29/2011
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