Provider Demographics
NPI:1578826806
Name:JEWELL, BARBARA FRANCES MARIE (MPA)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:FRANCES MARIE
Last Name:JEWELL
Suffix:
Gender:F
Credentials:MPA
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 1092
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:AK
Mailing Address - Zip Code:99574-1092
Mailing Address - Country:US
Mailing Address - Phone:907-424-8300
Mailing Address - Fax:907-424-8645
Practice Address - Street 1:602 CHASE AVE.
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:AK
Practice Address - Zip Code:99574
Practice Address - Country:US
Practice Address - Phone:907-424-8300
Practice Address - Fax:907-424-8645
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCMG287Medicaid