Provider Demographics
NPI:1477933885
Name:APASSINGOK, KRISTINA (CHA)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:APASSINGOK
Suffix:
Gender:F
Credentials:CHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 190
Mailing Address - Street 2:
Mailing Address - City:GAMBELL
Mailing Address - State:AK
Mailing Address - Zip Code:99742
Mailing Address - Country:US
Mailing Address - Phone:907-985-5012
Mailing Address - Fax:907-985-5085
Practice Address - Street 1:123 MAZ WAY
Practice Address - Street 2:
Practice Address - City:GAMBELL
Practice Address - State:AK
Practice Address - Zip Code:99742
Practice Address - Country:US
Practice Address - Phone:907-985-5012
Practice Address - Fax:907-985-5085
Is Sole Proprietor?:No
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKCHA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCHAOtherCHA