Individual
LYNELLE CC DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
43335 KALIFORNSKY BEACH RD STE 36, SOLDOTNA, AK 99669-8280
(907) 575-3742
(907) 262-6294
Mailing address
508 UPLAND ST, KENAI, AK 99611-8026
(907) 335-7500
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
12/16/2021
Last updated
04/30/2026
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