Provider Demographics
NPI:1336371574
Name:FINNEY, CAROLINE KANKANTON (CHP)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:KANKANTON
Last Name:FINNEY
Suffix:
Gender:F
Credentials:CHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 111
Mailing Address - Street 2:
Mailing Address - City:NAKNEK
Mailing Address - State:AK
Mailing Address - Zip Code:99633-0111
Mailing Address - Country:US
Mailing Address - Phone:907-246-2252
Mailing Address - Fax:
Practice Address - Street 1:3380 C. STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-277-1440
Practice Address - Fax:907-277-1446
Is Sole Proprietor?:No
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK171011002X1710I1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman