Provider Demographics
NPI:1629753652
Name:ADORNO-ARELLANO, KATELYN MICHAELA
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:MICHAELA
Last Name:ADORNO-ARELLANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:MICHAELA
Other - Last Name:GREIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:GREIST
Mailing Address - Street 1:4377 WHITE ST UNIT LEFT
Mailing Address - Street 2:
Mailing Address - City:FORT WAINWRIGHT
Mailing Address - State:AK
Mailing Address - Zip Code:99703-1310
Mailing Address - Country:US
Mailing Address - Phone:907-388-4333
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:4377 WHITE ST UNIT LEFT
Practice Address - Street 2:
Practice Address - City:FORT WAINWRIGHT
Practice Address - State:AK
Practice Address - Zip Code:99703-1310
Practice Address - Country:US
Practice Address - Phone:907-388-4333
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker