Johnson, Staci L

Johnson, Staci L is an sole proprietor health care provider with primary practice located at 2751 Debarr Rd Ste 310 , Anchorage AK 99508-6804. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Pain Management, Nursing Service Providers / Wound Care, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Johnson, Staci L can be contacted via phone (907) 277-9700.

Contact Information

Primary practice address
2751 Debarr Rd Ste 310 Anchorage AK 99508-6804
Phone: (907) 277-9700
Fax: (907) 868-1215
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Pain Management 163WP0000X 1097 Alaska
Nursing Service Providers / Wound Care 163WW0000X 1097 Alaska
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 1097 Alaska

Profile Details

NPI number 1538325907
LBN Legal business name Johnson, Staci L
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 5th, 2008
Last updated Sep 29th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538325907 NPPES
Alaska MEDICAID 1022282

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