Individual
KEISHA G OLANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CHA-T
Contact information
Practice address
62039 DAQUMAAQ ROAD, GOLOVIN, AK 99762-2039
(907) 779-3311
(907) 779-3312
Mailing address
PO BOX 62039, GOLOVIN, AK 99762-6039
(907) 779-3311
(907) 772-3312
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
10/14/2019
Last updated
10/14/2019
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