Calm Harbor Health Clinic
Organization Active NPI Family Nurse Practitioner · Ketchikan, AK
NPI 1124593512 · NPPES record last updated Mar 4, 2021
Key facts
- NPI
- 1124593512
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- Legal business name
- CALM HARBOR HEALTH CLINIC
- Practice address
- 3528 Tongass Ave
Ketchikan, AK 99901-5635 - Phone
- (907) 617-4481
- NPI assigned
- Oct 11, 2018
- Organization subpart
- No
Authorized official
- Name
- Mrs. Marina Judith-Rowe McIntyre, FNP
- Title
- Owner
- Phone
- (907) 617-4481
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | Yes |
Addresses
Primary practice location
3528 Tongass Ave
Ketchikan, AK 99901-5635
Mailing address
3528 Tongass Ave
Ketchikan, AK 99901-5635
Phone (907) 617-4481
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1612171 | Medicaid | AK |
Other names
- Calm Harbor Health Clinic
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All providers in Ketchikan, AK · Family Nurse Practitioner in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.