Provider Demographics
NPI:1477299618
Name:HAUNOLD, CIARA EMILY
Entity type:Individual
Prefix:
First Name:CIARA
Middle Name:EMILY
Last Name:HAUNOLD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1365 E PARKS HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-8298
Mailing Address - Country:US
Mailing Address - Phone:907-357-6445
Mailing Address - Fax:907-376-6402
Practice Address - Street 1:1365 E PARKS HIGHWAY
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-8298
Practice Address - Country:US
Practice Address - Phone:907-357-6445
Practice Address - Fax:907-376-6402
Is Sole Proprietor?:No
Enumeration Date:2022-05-10
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No175T00000XOther Service ProvidersPeer Specialist