Individual
SELMA JANE STONEBREAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PDHA II
Contact information
Practice address
222 TONGASS DR, SITKA, AK 99835-9416
(907) 966-8343
(907) 966-8663
Mailing address
222 TONGASS DR, SITKA, AK 99835-9416
(907) 966-8343
(907) 966-8663
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11-069-PDHAII
COMMUNITY HEALTH AIDE PROGRAM CERTIFICATION BOARD - FEDERAL CERTIFICATION
AK
Enumeration date
04/25/2012
Last updated
04/25/2012
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