Individual
KIMBERLY ANN MOLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PDHA II
Contact information
Practice address
101 TOTEM WAY, KAKE, AK 99830
(907) 785-6542
(907) 785-3136
Mailing address
PO BOX 605, KAKE, AK 99830-0605
(907) 785-6542
(907) 785-3136
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09-054-PDHAII
COMMUNITY HEALTH AIDE PROGRAM CERTIFICATION BOARD - FEDERAL CERTIFICAITON
AK
Enumeration date
04/23/2012
Last updated
04/23/2012
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