Organization · NPI-2

Calm Harbor Health Clinic

Nurse Practitioner, Family · Ketchikan, AK

NPI number1124593512
StatusActive
Last updated in NPPESMar 4, 2021

Details

NPI
1124593512
Entity type
Organization (NPI-2)
Legal business name
Calm Harbor Health Clinic
Organization subpart
No
Enumeration date
Oct 11, 2018
Certification date
Mar 4, 2021
Last updated
Mar 4, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family––Yes

Other names

  • Calm Harbor Health Clinic (Other Name)
  • Calm Harbor Health Clinic (Former Legal Business Name)

Practice location

3528 Tongass Ave
Ketchikan, AK 99901-5635

Phone 907-617-4481

Mailing address

3528 Tongass Ave
Ketchikan, AK 99901-5635

Phone 907-617-4481

Authorized official

Marina Judith-Rowe Mcintyre
Owner
9076174481

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