Individual
MR. ELIAS E KVASNIKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CHA III C
Contact information
Practice address
64834 NIKITA STREET, NANWALEK, AK 99603-8023
(907) 281-2250
(907) 281-2244
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MDH0191
—
AK
Enumeration date
07/29/2009
Last updated
05/22/2012
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