Provider Demographics
NPI:1952450728
Name:HUSKEY, KATHY ANNETTE (BSW)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:ANNETTE
Last Name:HUSKEY
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:CARE
Other - Middle Name:
Other - Last Name:PLANS, INC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:10244 COLVILLE ST
Mailing Address - Street 2:PO BOX 772483
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-7218
Mailing Address - Country:US
Mailing Address - Phone:907-696-3387
Mailing Address - Fax:907-696-3387
Practice Address - Street 1:10244 COLVILLE ST
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7218
Practice Address - Country:US
Practice Address - Phone:907-696-3387
Practice Address - Fax:907-696-3387
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator