Maureen Colleen Ticket, CHP
Individual provider Active NPI Community Health Worker · Selawik, AK
NPI 1871861963 · NPPES record last updated Dec 5, 2011
Key facts
- NPI
- 1871861963
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- License
- 11-1138-II (AK)
- Practice address
- #3 Adams Landing Old
Selawik, AK 99770-0180 - Phone
- (907) 484-2199
- Fax
- (907) 484-2119
- NPI assigned
- Dec 5, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11-1138-II | AK | MD | Community Health Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maniilaq Association | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 11-1138-II | AK | Yes |
Addresses
Primary practice location
#3 Adams Landing Old
Selawik, AK 99770-0180
Mailing address
PO Box 180
Selawik, AK 99770-0180
Phone (907) 484-2199
Other providers in Selawik, AK
All providers in Selawik, 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 Dec 5, 2011. 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.