Provider Demographics
NPI:1629066402
Name:WORKMAN, DARLENE L (CDC 11)
Entity Type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:L
Last Name:WORKMAN
Suffix:
Gender:F
Credentials:CDC 11
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 19TH AVE
Mailing Address - Street 2:CHIEF ANDREW ISAAC HEALTH CENTER
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-5903
Mailing Address - Country:US
Mailing Address - Phone:907-459-3800
Mailing Address - Fax:907-459-3810
Practice Address - Street 1:1408 19TH AVE
Practice Address - Street 2:CHIEF ANDREW ISAAC HEALTH CENTER
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-5903
Practice Address - Country:US
Practice Address - Phone:907-459-3800
Practice Address - Fax:907-459-3810
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)