Provider Demographics
NPI:1205650769
Name:UKATISH-GAHIMER, NICHOLI (CHA-I)
Entity type:Individual
Prefix:
First Name:NICHOLI
Middle Name:
Last Name:UKATISH-GAHIMER
Suffix:
Gender:M
Credentials:CHA-I
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 8005
Mailing Address - Street 2:
Mailing Address - City:NANWALEK
Mailing Address - State:AK
Mailing Address - Zip Code:99603-6605
Mailing Address - Country:US
Mailing Address - Phone:907-435-1463
Mailing Address - Fax:
Practice Address - Street 1:1 MAQIQ ST.
Practice Address - Street 2:
Practice Address - City:NANWALEK
Practice Address - State:AK
Practice Address - Zip Code:99603-6623
Practice Address - Country:US
Practice Address - Phone:907-281-2250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker