Individual
MERCEDES RENEE POULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
121 W FIREWEED LN STE 105, ANCHORAGE, AK 99503-2044
(907) 865-9653
Mailing address
121 W FIREWEED LN STE 105, ANCHORAGE, AK 99503-2044
(907) 865-9653
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
134862
AK
Other
Enumeration date
07/03/2018
Last updated
07/03/2018
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