Provider Demographics
NPI:1720971203
Name:DINGER, EILEEN MICHELLE
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:MICHELLE
Last Name:DINGER
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 1:1502 LIATRIS LN
Mailing Address - Street 2:
Mailing Address - City:NORTH POLE
Mailing Address - State:AK
Mailing Address - Zip Code:99705-5082
Mailing Address - Country:US
Mailing Address - Phone:904-588-2192
Mailing Address - Fax:
Practice Address - Street 1:1502 LIATRIS LN
Practice Address - Street 2:
Practice Address - City:NORTH POLE
Practice Address - State:AK
Practice Address - Zip Code:99705-5082
Practice Address - Country:US
Practice Address - Phone:904-588-2192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK526491172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker