Provider Demographics
NPI:1275954877
Name:SOCKPICK, HELEN
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:SOCKPICK
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 1:1000 GREG KRUSECK AVENUE
Mailing Address - Street 2:P.O. BOX 966
Mailing Address - City:NOME
Mailing Address - State:AK
Mailing Address - Zip Code:99760
Mailing Address - Country:US
Mailing Address - Phone:907-443-3311
Mailing Address - Fax:907-443-3471
Practice Address - Street 1:1000 GREG KRUSECK AVENUE
Practice Address - Street 2:BOX 966
Practice Address - City:NOME
Practice Address - State:AK
Practice Address - Zip Code:99760
Practice Address - Country:US
Practice Address - Phone:907-443-3311
Practice Address - Fax:907-443-3471
Is Sole Proprietor?:No
Enumeration Date:2013-12-27
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK07-946-IV172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK07-946-IVOtherCHA IV