Organization
PETALOSO INC
Active
Other names
Petaloso
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE L STABLES MSN, ANP (PRESIDENT)
(907) 978-7721
Entity
Organization
Contact information
Practice address
1867 AIRPORT WAY STE 110B, FAIRBANKS, AK 99701-4054
(907) 978-7721
(907) 452-6330
Mailing address
1867 AIRPORT WAY STE 110B, FAIRBANKS, AK 99701-4054
(907) 978-7721
(907) 452-6330
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
420
AK
Other
Enumeration date
04/27/2016
Last updated
04/27/2016
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