Basic Information
| Provider Information | |||||||||
| NPI: | 1841783321 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LITTLEFISH | ||||||||
| FirstName: | ALEXIE | ||||||||
| MiddleName: | M | ||||||||
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| Mailing Information | |||||||||
| Address1: | CHURCH ROAD 01 | ||||||||
| Address2: | |||||||||
| City: | LOWER KALSKAG | ||||||||
| State: | AK | ||||||||
| PostalCode: | 99626 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9074712347 | ||||||||
| FaxNumber: | 9074712258 | ||||||||
| Practice Location | |||||||||
| Address1: | CHURCH ROAD 01 | ||||||||
| Address2: | |||||||||
| City: | LOWER KALSKAG | ||||||||
| State: | AK | ||||||||
| PostalCode: | 99626 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9074712347 | ||||||||
| FaxNumber: | 9074712258 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2018 | ||||||||
| LastUpdateDate: | 06/11/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 172V00000X | AK | Y | Other Service Providers | Community Health Worker |
No ID Information.