Organization · Type 2 NPI
Kic Tribal Health Clinic
Federally Qualified Health Center (FQHC) · Ketchikan, AK
NPI number
1043533946
Active
Practice location
2960 Tongass Ave
Ketchikan, AK 99901-5742
Fax (907) 228-4905
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Federally Qualified Health Center (FQHC) Primary | 261QF0400X | 10728 (AK) |
Federally Qualified Health Center (FQHC): Definition to come...
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- Kic Tribal Health ClinicHealth Service Clinic/Center Ketchikan, AK NPI 1124341896
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- Ahmad I. Shafi, MDGeneral Practice Physician Ketchikan, AK NPI 1851331862
- Amy J. Nichols, MDGeneral Practice Physician Ketchikan, AK NPI 1487807814
- Andre M. Lecornu, RNRegistered Nurse Ketchikan, AK NPI 1447382809
- Ann Nora Ehret, DOFamily Medicine Physician Ketchikan, AK NPI 1386672400
- Blake Bachant, PharmDAmbulatory Care Pharmacist Ketchikan, AK NPI 1477382786
About NPI 1043533946
Kic Tribal Health Clinic's National Provider Identifier is 1043533946, issued on Mar 5, 2010. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Ketchikan, AK. The record was last updated on Mar 5, 2010.