Provider Demographics
NPI:1962891283
Name:TOYUKAK, BERNICE
Entity type:Individual
Prefix:
First Name:BERNICE
Middle Name:
Last Name:TOYUKAK
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:PO BOX 311
Mailing Address - Street 2:
Mailing Address - City:TOGIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99678-0311
Mailing Address - Country:US
Mailing Address - Phone:907-493-5511
Mailing Address - Fax:
Practice Address - Street 1:311 OLD AIRPORT ROAD
Practice Address - Street 2:
Practice Address - City:TOGIAK
Practice Address - State:AK
Practice Address - Zip Code:99678-0311
Practice Address - Country:US
Practice Address - Phone:907-493-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK08-966-IIII172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker