Individual
MARILYN KOEZUNA-IRELAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
306 WEST 5TH AVENUE, NOME, AK 99762-0966
(907) 443-3311
(907) 443-7983
Mailing address
306 WEST 5TH AVENUE, NOME, AK 99762-0966
(907) 443-3311
(907) 443-7983
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMG414
—
AK
05
—
HC4141
—
AK
Enumeration date
06/22/2009
Last updated
06/22/2009
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