Provider Demographics
NPI:1164161956
Name:WALKOFF, STORMY (BHA-T)
Entity Type:Individual
Prefix:
First Name:STORMY
Middle Name:
Last Name:WALKOFF
Suffix:
Gender:F
Credentials:BHA-T
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 39368
Mailing Address - Street 2:
Mailing Address - City:NINILCHIK
Mailing Address - State:AK
Mailing Address - Zip Code:99639-0368
Mailing Address - Country:US
Mailing Address - Phone:190-730-2737
Mailing Address - Fax:
Practice Address - Street 1:15765 STERLING HWY
Practice Address - Street 2:
Practice Address - City:NINILCHIK
Practice Address - State:AK
Practice Address - Zip Code:99639
Practice Address - Country:US
Practice Address - Phone:907-567-3370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator