Wade Bror Clauson, LPN

Individual provider Active NPI Licensed Practical Nurse · Jber, AK

NPI 1821363532 · NPPES record last updated Mar 13, 2012

Key facts

NPI
1821363532
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
6820 (AK)
Practice address
7411 Metzger Ave Unit B
Jber, AK 99506-2022
Phone
(907) 330-9779
NPI assigned
Mar 13, 2012
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
EMT530361FLMDBasic Emergency Medical Technician
6820AKMDLicensed Practical Nurse
PN5199765FLMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X EMT530361 FL
Licensed Practical Nurse 164W00000X 6820 AK Yes
Licensed Practical Nurse 164W00000X PN5199765 FL

Addresses

Primary practice location

7411 Metzger Ave Unit B
Jber, AK 99506-2022

Mailing address

7411 Metzger Ave Unit B
Jber, AK 99506
Phone (907) 330-9779

Other providers in Jber, AK

All providers in Jber, AK · Licensed Practical Nurse in Alaska

Sources for this page

Verify at the official NPI Registry.