Provider Demographics
NPI:1659768638
Name:NAKAK, MAASINGAH (CHA-II)
Entity Type:Individual
Prefix:
First Name:MAASINGAH
Middle Name:
Last Name:NAKAK
Suffix:
Gender:F
Credentials:CHA-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 BAKER STREET
Mailing Address - Street 2:
Mailing Address - City:ST.MICHAEL
Mailing Address - State:AK
Mailing Address - Zip Code:99659
Mailing Address - Country:US
Mailing Address - Phone:907-923-3311
Mailing Address - Fax:907-923-2287
Practice Address - Street 1:94 BAKER STREET
Practice Address - Street 2:
Practice Address - City:ST.MICHAEL
Practice Address - State:AK
Practice Address - Zip Code:99659
Practice Address - Country:US
Practice Address - Phone:907-923-3311
Practice Address - Fax:907-923-2287
Is Sole Proprietor?:No
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCHA-IIOtherCHA-II