Individual
JASON DREW SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3180 PEGER RD, FAIRBANKS, AK 99709-5484
(907) 455-9737
Mailing address
3180 PEGER RD, FAIRBANKS, AK 99709-5484
(907) 455-9737
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
215106
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
215106
ALASKA BOARD OF NURSING
AK
Enumeration date
08/20/2024
Last updated
08/20/2024
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