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Individual

IDA J KERNAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BHCA

Contact information

Practice address
225 EAGLE ST, ANCHORAGE, AK 99501-2626
(907) 729-6550
Mailing address
7033 E TUDOR RD, ANCHORAGE, AK 99507-1262
(907) 729-6801
(907) 729-5180

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
AK
172V00000X
Community Health Worker
Primary
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1020986
AK
Enumeration date
01/08/2013
Last updated
03/11/2026
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