Koozaata, Channa Lisa

Koozaata, Channa Lisa is an individual health care provider with primary practice located at 190 Gravel Road , Gambell AK 99742-0190. She recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as her primary health care specialty. Koozaata, Channa Lisa can be contacted via phone (907) 985-5012.

Contact Information

Primary practice address
190 Gravel Road Gambell AK 99742-0190
Phone: (907) 985-5012
Fax: (907) 985-5085
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Community Health Worker 172V00000X 10-1073-III Alaska

Profile Details

NPI number 1053653691
LBN Legal business name Koozaata, Channa Lisa
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2013
Last updated Mar 21st, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053653691 NPPES
Alaska Other 10-1073-III CHA III

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