Petaloso INC

NPI #1982059952 in Fairbanks, Alaska

Provider Information

NPI Number
1982059952
Entity Type
Organization
Organization Name
Petaloso INC
Primary Specialty
Nurse Practitioner - Family
Enumeration Date
Apr 27, 2016
Last Updated
Apr 27, 2016

Practice Location

Address
1867 AIRPORT WAY STE 110B
State
Alaska
ZIP Code
99701-4054
Phone
(907) 978-7721

Authorized Official

Name
JANICE L STABLES, MSN, ANP
Title
PRESIDENT
Phone
(907) 978-7721

Specialties & Taxonomy Codes

Specialty
Nurse Practitioner - FamilyFamily

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