Provider Demographics
NPI:1598309528
Name:HOLLANDSWORTH, KATE LYNN (COMMUNITY HEALTH AID)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:LYNN
Last Name:HOLLANDSWORTH
Suffix:
Gender:F
Credentials:COMMUNITY HEALTH AID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SPRUCE STREET
Mailing Address - Street 2:
Mailing Address - City:FORT YUKON
Mailing Address - State:AK
Mailing Address - Zip Code:99740
Mailing Address - Country:US
Mailing Address - Phone:907-662-2460
Mailing Address - Fax:
Practice Address - Street 1:30 MAIN STREET
Practice Address - Street 2:
Practice Address - City:ARCTIC VILLAGE
Practice Address - State:AK
Practice Address - Zip Code:99722
Practice Address - Country:US
Practice Address - Phone:907-587-5229
Practice Address - Fax:907-587-5239
Is Sole Proprietor?:No
Enumeration Date:2019-11-02
Last Update Date:2019-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker