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Individual

MEGANNE JEAN MARIE CLARKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3245 HOSPITAL DR, JUNEAU, AK 99801-7809
(907) 789-5437
Mailing address
3100 CHANNEL DR STE 300, JUNEAU, AK 99801-7837
(907) 789-5437

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
22-164-PDHAI
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22-164-PDHAI
COMMUNITY HEALTH AIDE PROGRAM CERTIFICATION BOARD - FEDERAL CERTIFICATION
AK
Enumeration date
07/26/2022
Last updated
07/26/2022
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