Organization
FIREWEED SURGICAL ASSISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH WOOD JOHANSON NP (ACUTE CARE NURSE PRACTITIONER)
(503) 507-4516
Entity
Organization
Contact information
Practice address
2500 S WOODWORTH LOOP, PALMER, AK 99645-8984
(508) 579-2174
Mailing address
1150 S COLONY WAY SUITE #3, PMB 153, PALMER, AK 99645
(508) 579-2174
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/31/2017
Last updated
08/07/2024
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