Rhonda M Jackson
Individual provider Active NPI Community Health Worker · Kwethluk, AK
NPI 1164062386 · NPPES record last updated Jan 15, 2020
Key facts
- NPI
- 1164062386
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- Practice address
- 49 Airport Road
Kwethluk, AK 99621-0069 - Phone
- (907) 757-6627
- Fax
- (907) 757-6626
- NPI assigned
- Jan 15, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Yes |
Addresses
Primary practice location
49 Airport Road
Kwethluk, AK 99621-0069
Mailing address
PO Box 69
Kwethluk, AK 99621-0069
Phone (907) 757-6627
Other providers in Kwethluk, AK
- Jacqueline M Alexie
- Katrina Crane
- Patricia M.M. David
- Willie Nick David
- Jordan T Fisher
- Richard Long
- Charlamagne C Olick
- Alexandra Peterson
- Carla Suskuk
All providers in Kwethluk, AK · Community Health Worker in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2020. 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.