MEDICARE: HAZEL FLYNN CHA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker		AK

General Provider Information

NPI Number	:	1457609364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAZEL FLYNN CHA

Provider Business Mailing Address
First Line	:	PO BOX 528
Second Line	:
City	:	BETHEL
State	:	AK
Zip	:	99559-0528
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 CHIEF EDDIE HOFFMAN HIGHWAY
Second Line	:
City	:	BETHEL
State	:	AK
Zip	:	99559-0528
Country	:	US
Telephone Number	:	907-543-6300
Fax Number	:	907-543-6366

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2012
Last Update Date	:	06/10/2026

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Directions to “ HAZEL FLYNN CHA” Practice Location

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