Individual
THENELUS TRACEY WHITFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
670 W FIREWEED LN STE 160, ANCHORAGE, AK 99503-2561
(907) 770-0862
Mailing address
3629 REMINGTON GROVE AVE, NORTH LAS VEGAS, NV 89081-4084
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
194409
AK
Other
Enumeration date
08/25/2022
Last updated
08/25/2022
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