Provider Demographics
NPI:1477981231
Name:HERBERT, CHASITY
Entity Type:Individual
Prefix:
First Name:CHASITY
Middle Name:
Last Name:HERBERT
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 1:2ND ST.
Mailing Address - Street 2:
Mailing Address - City:CHALKYITSIK
Mailing Address - State:AK
Mailing Address - Zip Code:99788
Mailing Address - Country:US
Mailing Address - Phone:907-848-8215
Mailing Address - Fax:907-848-8216
Practice Address - Street 1:2ND ST.
Practice Address - Street 2:
Practice Address - City:CHALKYITSIK
Practice Address - State:AK
Practice Address - Zip Code:99788
Practice Address - Country:US
Practice Address - Phone:907-848-8215
Practice Address - Fax:907-848-8216
Is Sole Proprietor?:No
Enumeration Date:2013-10-14
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker