Provider Demographics
NPI:1316566482
Name:MCARTHUR, ROSANNA MARIE
Entity Type:Individual
Prefix:MRS
First Name:ROSANNA
Middle Name:MARIE
Last Name:MCARTHUR
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:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:CHIGNIK
Mailing Address - State:AK
Mailing Address - Zip Code:99564-0009
Mailing Address - Country:US
Mailing Address - Phone:435-313-6642
Mailing Address - Fax:
Practice Address - Street 1:100 SCHOOL ROAD
Practice Address - Street 2:
Practice Address - City:CHIGNIK BAY
Practice Address - State:AK
Practice Address - Zip Code:99564
Practice Address - Country:US
Practice Address - Phone:435-313-6642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK20-1611-I172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker