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Contact Information

CRYSTAL B TICKETT
80 BACK STREET
SHUNGNAK, AK99778
 Phone: 907-437-2138
 Fax: 907-437-2139
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community Health Worker

172V00000X
 

Mental Health

101YM0800X
Indicates primary specialty

NPI Profile & details for CRYSTAL B TICKETT · (Female)

NPI # 1215569264
Status Active
Credentials
Entity Individual
Enumeration date 02/07/2020
Last updated 06/23/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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