Individual
DOLLY IRENE KIYUTELLUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
133 LAGOON VIEW, SHISHMAREF, AK 99772
(907) 649-3311
(907) 649-2083
Mailing address
133 LAGOON VIEW, SHISHMAREF, AK 99772
(907) 649-3311
(907) 649-2083
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CHA III-C
CHA III-C
AK
Enumeration date
12/11/2014
Last updated
12/11/2014
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