Provider Demographics
NPI:1467825745
Name:SUKO, TONI (CHA II)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:SUKO
Suffix:
Gender:F
Credentials:CHA II
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 56
Mailing Address - Street 2:
Mailing Address - City:CANTWELL
Mailing Address - State:AK
Mailing Address - Zip Code:99729-0056
Mailing Address - Country:US
Mailing Address - Phone:907-768-2122
Mailing Address - Fax:907-768-2150
Practice Address - Street 1:MILE MARKER 133.2
Practice Address - Street 2:DENALI HIGHWAY
Practice Address - City:CANTWELL
Practice Address - State:AK
Practice Address - Zip Code:99729
Practice Address - Country:US
Practice Address - Phone:907-768-2122
Practice Address - Fax:907-768-2150
Is Sole Proprietor?:No
Enumeration Date:2015-11-09
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker