PETALOSO INC NPI 1982059952

NPI Information

PETALOSO INC is a family nurse practitioner in Fairbanks, AK. PETALOSO INC NPI is 1982059952. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Petaloso.

The provider's business location address is:

1867 AIRPORT WAY STE 110B
FAIRBANKS, AK
ZIP 99701-054
Phone: (907) 978-7721
Fax: (907) 452-6330

The provider's authorized official is Janice L Stables .
The authorized official title is President and has the following contact phone number (907) 978-7721.

The CLIA number assigned to this NPI record is 02D2111698 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/27/2016 and was last updated on 4/27/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.