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MS. EVELYN LOUISE CLOUGH ANP, CDCII

Addiction Substance Use Disorder

Soldotna, Alaska

Provider NPI: 1124092655

Provider Information:
MS. EVELYN LOUISE CLOUGH ANP, CDCII
Gender: F
Sole Proprietor


Practice Location:
44539 STERLING HWY SUITE 105 SOLDOTNA, AK 99669 US
Tel: 907-262-5324  Fax: 907-260-7464

Business Mailing Address:
PO BOX 1015  SOLDOTNA, AK 99669 US
Tel: 907-262-5324  Fax: 907-260-7464

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
AK1091
Y363LP0808XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
AK668

Other Provider Identifiers:

IssuerNumberStateType
NP4248AK05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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