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CALM HARBOR HEALTH CLINIC NPI 1124593512


NPI Information

NPI: 1124593512
Provider Name: CALM HARBOR HEALTH CLINIC

Other Name: CALM HARBOR HEALTH CLINIC

Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
3528 TONGASS AVE
KETCHIKAN, AK
ZIP 99901
Phone: (907) 617-4481
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CALM HARBOR HEALTH CLINIC is a family nurse practitioner in Ketchikan, AK. CALM HARBOR HEALTH CLINIC NPI is 1124593512. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Calm Harbor Health Clinic.

The provider's business location address is:

3528 TONGASS AVE
KETCHIKAN, AK
ZIP 99901-635
Phone: (907) 617-4481

The provider's authorized official is Marina Judith-rowe Mcintyre .
The authorized official title is Owner and has the following contact phone number (907) 617-4481.

The enumeration date for this NPI number is 10/11/2018 and was last updated on 3/4/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LF0000XNurse PractitionerFamilyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11612171MEDICAIDALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.