Provider Demographics
NPI:1295144129
Name:CALLAHAN, RAQUEL R (BSN, RN)
Entity type:Individual
Prefix:MRS
First Name:RAQUEL
Middle Name:R
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 WOODLAND DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99517-2555
Mailing Address - Country:US
Mailing Address - Phone:907-644-6050
Mailing Address - Fax:907-644-4438
Practice Address - Street 1:3700 WOODLAND DR
Practice Address - Street 2:SUITE 500
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99517-2555
Practice Address - Country:US
Practice Address - Phone:907-644-6050
Practice Address - Fax:907-644-4438
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator