Provider Demographics
NPI:1902174972
Name:CONWELL, LOUISE SARAH (CARE COORDINATOR)
Entity type:Individual
Prefix:MS
First Name:LOUISE
Middle Name:SARAH
Last Name:CONWELL
Suffix:
Gender:F
Credentials:CARE COORDINATOR
Other - Prefix:MRS
Other - First Name:LOUISE
Other - Middle Name:SARAH
Other - Last Name:WOLFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CARE COORDINATOR
Mailing Address - Street 1:PO BOX 256
Mailing Address - Street 2:818 LAKESTREET
Mailing Address - City:KOTZEBUE
Mailing Address - State:AK
Mailing Address - Zip Code:99752-0256
Mailing Address - Country:US
Mailing Address - Phone:907-442-7935
Mailing Address - Fax:
Practice Address - Street 1:818 LAKESTREET
Practice Address - Street 2:
Practice Address - City:KOTZEBUE
Practice Address - State:AK
Practice Address - Zip Code:99752-0256
Practice Address - Country:US
Practice Address - Phone:907-442-7935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator