Individual
ANGELA LUCIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1717 W COWLES ST, FAIRBANKS, AK 99701-5926
(907) 452-8251
Mailing address
201 1ST AVE, FAIRBANKS, AK 99701-4848
(907) 452-8251
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
AK1204
AK
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1620803
—
AK
Enumeration date
07/29/2014
Last updated
11/16/2017
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