Provider Demographics
NPI:1235394537
Name:JEMEWOUK, DARLENE E
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:E
Last Name:JEMEWOUK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DARLENE
Other - Middle Name:E
Other - Last Name:KATCHATAG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 966
Mailing Address - Street 2:
Mailing Address - City:NOME
Mailing Address - State:AK
Mailing Address - Zip Code:99762-0966
Mailing Address - Country:US
Mailing Address - Phone:907-443-3311
Mailing Address - Fax:907-443-7983
Practice Address - Street 1:306 W 5TH AVENUE
Practice Address - Street 2:
Practice Address - City:NOME
Practice Address - State:AK
Practice Address - Zip Code:99762-0966
Practice Address - Country:US
Practice Address - Phone:907-443-3311
Practice Address - Fax:907-443-7983
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist