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Individual

JAMES RONALD STATEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
121 W FIREWEED LN STE 105, ANCHORAGE, AK 99503-2044
(907) 865-9653
(907) 865-9124
Mailing address
121 W FIREWEED LN STE 105, ANCHORAGE, AK 99503-2044
(907) 865-9653
(907) 865-9124

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
7150
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1831502822
AK
Enumeration date
09/23/2014
Last updated
02/05/2018
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