Provider Demographics
NPI:1215732482
Name:JOHNSON, ARABELLA ROSEMARY-AMY (CHA)
Entity type:Individual
Prefix:
First Name:ARABELLA
Middle Name:ROSEMARY-AMY
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CHA
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 56
Mailing Address - Street 2:
Mailing Address - City:CANTWELL
Mailing Address - State:AK
Mailing Address - Zip Code:99729-0056
Mailing Address - Country:US
Mailing Address - Phone:907-768-2122
Mailing Address - Fax:907-768-2150
Practice Address - Street 1:MP 133.2 DENALI HWY
Practice Address - Street 2:
Practice Address - City:CANTWELL
Practice Address - State:AK
Practice Address - Zip Code:99729
Practice Address - Country:US
Practice Address - Phone:907-768-2122
Practice Address - Fax:907-768-2150
Is Sole Proprietor?:No
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK25-1777-1172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker