Provider Demographics
NPI:1093505547
Name:PANIPTCHUK, JANELLE D (CHA-T)
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:D
Last Name:PANIPTCHUK
Suffix:
Gender:
Credentials:CHA-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 GREG KRUSHEK AVE
Mailing Address - Street 2:
Mailing Address - City:NOME
Mailing Address - State:AK
Mailing Address - Zip Code:99762
Mailing Address - Country:US
Mailing Address - Phone:907-443-3311
Mailing Address - Fax:907-443-3471
Practice Address - Street 1:P.O. BOX 09
Practice Address - Street 2:
Practice Address - City:SHAKTOOLIK
Practice Address - State:AK
Practice Address - Zip Code:99771-0009
Practice Address - Country:US
Practice Address - Phone:907-955-3311
Practice Address - Fax:907-955-2342
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker