Provider Demographics
NPI:1073924247
Name:TUOL, NYADENG
Entity Type:Individual
Prefix:
First Name:NYADENG
Middle Name:
Last Name:TUOL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 OCEANVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-3906
Mailing Address - Country:US
Mailing Address - Phone:907-248-4669
Mailing Address - Fax:
Practice Address - Street 1:1111 OCEANVIEW DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-3906
Practice Address - Country:US
Practice Address - Phone:907-248-4669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-09
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant