Deanna Leigh Kosbruk, CHA-1

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

NPI 1851817449 · NPPES record last updated Aug 16, 2017

Key facts

NPI
1851817449
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
Practice address
Mile 111.5
Copper Center, AK 99573-0508
Phone
(907) 822-5241
Fax
(888) 959-2389
NPI assigned
Aug 16, 2017
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

Mile 111.5
Copper Center, AK 99573-0508

Mailing address

PO Box H
Copper Center, AK 99573-0508
Phone (907) 822-5241

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.