Individual
BERNICE HETHERINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
122 1ST AVE STE 400, FAIRBANKS, AK 99701-4871
(907) 459-3800
Mailing address
PO BOX 60102, FAIRBANKS, AK 99706-0102
(907) 452-8251
(907) 459-3810
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020986
—
AK
Enumeration date
08/06/2009
Last updated
12/02/2022
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