Individual
MARY NATHANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
102 BELL ST, CHALKYITSIK, AK 99788
(907) 848-8215
(907) 848-8696
Mailing address
1717 COWLES ST, FAIRBANKS, AK 99701-5926
(907) 452-8251
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
05/24/2013
Last updated
05/24/2013
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