Provider Demographics
NPI:1740470921
Name:EAVES, CLAUDIA COOK (MS)
Entity type:Individual
Prefix:MRS
First Name:CLAUDIA
Middle Name:COOK
Last Name:EAVES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20322 NEW ENGLAND DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-7114
Mailing Address - Country:US
Mailing Address - Phone:907-694-4799
Mailing Address - Fax:907-694-0223
Practice Address - Street 1:20322 NEW ENGLAND DR
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7114
Practice Address - Country:US
Practice Address - Phone:907-694-4799
Practice Address - Fax:907-694-0223
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKCM6431171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCM6431Medicaid