Individual
TIFFANY NICOLE BEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
839 CHIEF EDDIE HOFFMAN HWY, BETHEL, AK 99559-0528
(907) 543-2740
(907) 543-6729
Mailing address
PO BOX 528, ATTN: BH MALONE HOME PROGRAM, BETHEL, AK 99559-0528
(907) 543-2740
(907) 543-6729
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
376K00000X
Nurse's Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1005573
—
AK
05
—
1020986
—
AK
Enumeration date
05/14/2014
Last updated
05/14/2014
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