Individual
SHELIS R JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADVANCED NURSE PRACT
Contact information
Practice address
209 W EVERGREEN AVE STE A, PALMER, AK 99645-6952
(907) 861-1450
(907) 861-1460
Mailing address
209 W EVERGREEN AVE, PALMER, AK 99645-6952
(907) 861-1450
(907) 861-1460
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
CM3761
AK
363LF0000X
Family Nurse Practitioner
Primary
NURU798
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022309
—
AK
Enumeration date
03/20/2006
Last updated
10/17/2023
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