Carolyn Nora David, CHP

Individual provider Active NPI Community Health Worker · Copper Center, AK

NPI 1669902680 · NPPES record last updated Jun 10, 2022

Key facts

NPI
1669902680
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
License
PENDING (AK)
Practice address
111.5 Richardson Highway
Copper Center, AK 99573-0508
Phone
(907) 822-5241
NPI assigned
Jun 13, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PENDINGAKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Copper River Native Association Current
since Jul 24, 2022
Accepting new patients
Copper River Native Association Current
since Jun 12, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X PENDING AK Yes

Addresses

Primary practice location

111.5 Richardson Highway
Copper Center, AK 99573-0508

Mailing address

111.5 Richardson Highway
Copper Center, AK 99573-0508
Phone (907) 822-5241

Other practice location 1

Mile 5.9 Mentasta Spur Road
Mentasta Lake, AK 99780
Phone (907) 291-2320

Other providers in Copper Center, AK

All providers in Copper Center, AK · Community Health Worker in Alaska

Sources for this page

Verify at the official NPI Registry.