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Individual

NICHOLAS MIKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CHP

Contact information

Practice address
1008 AIRPORT RD, KOKHANOK, AK 99606
(907) 282-2203
Mailing address
1008 AIRPORT RD, KOKHANOK, AK 99606-1008
(907) 282-2203
(907) 282-2240

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
AK
376K00000X
Nurse's Aide
AK

Other

Enumeration date
03/20/2019
Last updated
09/28/2023
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