Individual
SHANELLE CREE BERGAMASCHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CHA-T
Contact information
Practice address
1 SCOW JOHN ROAD, WHITE MOUNTAIN, AK 99784-0029
(907) 638-3311
(907) 638-2007
Mailing address
PO BOX 966, NOME, AK 99762-0966
(907) 443-3311
(907) 443-3471
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CHA-T
CHA-T
—
Enumeration date
06/07/2022
Last updated
06/07/2022
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