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Individual

AMY LE ANNA JANSEN

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
304 W BASS AVE, YUKON, OK 73099-3945
(405) 669-1801

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
151343
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
151343
AK
Enumeration date
10/02/2019
Last updated
10/02/2019
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