CH- 11111D1Mrs. KATE ALLENA

PREFER METHOD OF
COMMUNICATION

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GENDER

FEMALE

PHONE NUMBER

(+1) 234 - 435698

ENROLLMENT TYPE

-

D.O.B

07/12/1957 (66 years 2 months 14 days)

WHATSAPP

(+1) 234 - 435698

ETHNICITY

Multiracial Americans

MARITAL STATUS

Married

EMAIL

kateallena@gmail.com

REGISTRATION DATE

07/12/2023

RISK SCORE

3.1

Address

908 Smythe St, Fairbanks, AK 99701, USA

Mailing Address

908 Smythe St, Fairbanks, AK 99701, USA

PRIMARY INSURANCE DETAILS

INSURANCE NAME

United Health

INSURANCE ID

786903748929099A

GROUP NUMBER

9581417962

EXPIRED DATE

12/31/2023

COPAY

$20

DEDUCTBLE

$500

SECONDARY INSURANCE DETAILS

INSURANCE NAME

United Health

INSURANCE ID

786903748929099A

GROUP NUMBER

9581417962

EXPIRED DATE

12/31/2023

COPAY

$20

DEDUCTBLE

$500

EMERGENCY CONTACT-1

NAME

Liam Doe

WORK PHONE

(+1) 47546 12758

RELATIONSHIP

Brother

CELL PHONE

(+1) 14586 45768

HOME PHONE

(+1) 12546 25842

EMERGENCY CONTACT-2

NAME

Noah Doe

WORK PHONE

(+1) 47546 12758

RELATIONSHIP

Elder Brother

CELL PHONE

(+1) 14586 45768

HOME PHONE

(+1) 12546 25842