Carly Donald

Individual provider Active NPI Community Health Worker · Fairbanks, AK

NPI 1730832015 · NPPES record last updated Jan 27, 2022

Key facts

NPI
1730832015
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
Practice address
1825 Marika Rd
Fairbanks, AK 99709-5521
Phone
(907) 474-0890
Fax
(907) 474-3621
NPI assigned
Jan 27, 2022
Sex
Female
Sole proprietor
Yes

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)CodeLicenseStatePrimary
Community Health Worker 172V00000X Yes

Addresses

Primary practice location

1825 Marika Rd
Fairbanks, AK 99709-5521

Mailing address

1825 Marika Rd
Fairbanks, AK 99709-5521
Phone (907) 474-0890

Other providers in Fairbanks, AK

All providers in Fairbanks, AK · Community Health Worker in Alaska

Sources for this page

Verify at the official NPI Registry.