Individual
STACI L JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2751 DEBARR RD STE 310, ANCHORAGE, AK 99508-6804
(907) 277-9700
(907) 868-1215
Mailing address
2751 DEBARR RD STE 310, ANCHORAGE, AK 99508-6804
(907) 277-9700
(907) 868-1215
Taxonomy
Speciality
Code
Description
License number
State
163WP0000X
Pain Management Registered Nurse
1097
AK
163WW0000X
Wound Care Registered Nurse
1097
AK
363LF0000X
Family Nurse Practitioner
Primary
1097
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022282
—
AK
Enumeration date
08/05/2008
Last updated
09/29/2020
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