Individual
AUDREY EILEEN SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
355 CARLANNA LAKE RD LOWR, KETCHIKAN, AK 99901-5614
(907) 225-1231
(907) 247-1231
Mailing address
PO BOX 5098, KETCHIKAN, AK 99901-0033
(907) 225-1231
(907) 247-1231
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
524
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NM5982
—
AK
Enumeration date
05/21/2007
Last updated
07/09/2007
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