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Individual

RENEE ROSE KIMAKTOAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CHA-T

Contact information

Practice address
1000 GREG KRUSHEK AVE, NOME, AK 99762-0966
(907) 624-3535
(907) 624-3692
Mailing address
PO BOX 189, UNALAKLEET, AK 99684-0189
(907) 624-3535
(907) 624-3692

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CHA-T
CHA-T
AK
Enumeration date
05/14/2020
Last updated
05/14/2020
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