Provider Demographics
NPI:1124149091
Name:CUTCHER, SHAWNDA ARLEYNE
Entity type:Individual
Prefix:MS
First Name:SHAWNDA
Middle Name:ARLEYNE
Last Name:CUTCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7036 WEIMER RD APT 4
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-2943
Mailing Address - Country:US
Mailing Address - Phone:907-764-4695
Mailing Address - Fax:
Practice Address - Street 1:7036 WEIMER ROAD, #4
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502
Practice Address - Country:US
Practice Address - Phone:907-764-4695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCM57202Medicaid