Provider Demographics
NPI:1679955777
Name:HAHNKAMP, CHARLEE
Entity Type:Individual
Prefix:MS
First Name:CHARLEE
Middle Name:
Last Name:HAHNKAMP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1867 AIRPORT WAY
Mailing Address - Street 2:STE 130 B
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-4054
Mailing Address - Country:US
Mailing Address - Phone:907-452-2178
Mailing Address - Fax:
Practice Address - Street 1:1867 AIRPORT WAY
Practice Address - Street 2:STE 130 B
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4054
Practice Address - Country:US
Practice Address - Phone:907-452-2178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant