Individual
MISS REBA OLIVIA ROSE DUNDAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PDHA II
Contact information
Practice address
222 TONGASS DR, SITKA, AK 99835-9416
(907) 966-8343
Mailing address
432 KIRKMAN DRIVE, SITKA, AK 99835
(907) 617-8113
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17-143-PDHAII
COMMUNITY HEALTH AIDE PROGRAM CERTIFICATION BOARD - FEDERAL CERTIFICATION
AK
Enumeration date
11/15/2017
Last updated
11/15/2017
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