Provider Demographics
NPI:1093173361
Name:AHKINGA, FLORENCE (CHA)
Entity Type:Individual
Prefix:
First Name:FLORENCE
Middle Name:
Last Name:AHKINGA
Suffix:
Gender:F
Credentials:CHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7059
Mailing Address - Street 2:
Mailing Address - City:LITTLE DIOMEDE
Mailing Address - State:AK
Mailing Address - Zip Code:99762-7059
Mailing Address - Country:US
Mailing Address - Phone:907-686-3311
Mailing Address - Fax:907-686-2181
Practice Address - Street 1:BUILDING 7059
Practice Address - Street 2:
Practice Address - City:LITTLE DIOMEDE
Practice Address - State:AK
Practice Address - Zip Code:99762-7059
Practice Address - Country:US
Practice Address - Phone:907-686-3311
Practice Address - Fax:907-686-2181
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCHAOtherCHA