Individual
MRS. CHARLEMAGNE MARIE MCMULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CHP-C
Contact information
Practice address
8023 MAIN STREET, NANWALEK, AK 99603
(907) 224-4908
(907) 224-5870
Mailing address
PO BOX 8023, NANWALEK, AK 99603-6623
(907) 281-2250
(907) 281-2244
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
07-937-P
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MDH0190
—
AK
Enumeration date
04/24/2009
Last updated
05/23/2012
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