Individual
ANGELA MARIE PENATAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HEALTH AIDE
Contact information
Practice address
1825 MARIKA RD, FAIRBANKS, AK 99709-5521
(907) 888-3416
Mailing address
707 16TH AVE APT 3, FAIRBANKS, AK 99701-6172
(907) 888-3416
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/21/2024
Last updated
08/21/2024
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