Marvin J. Stickwan, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

27807 Issued in AK

Practice address

7300 Klawock-Hollis Hwy.
Klawock, AK 99925

Phone

(907) 755-4800

NPI assigned

Dec 26, 2007

Last updated

Dec 26, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South East Alaska Regional Health Consortium

  dba Alicia Roberts Medical Center

  • Clinic/Center
  • Klawock, AK
  • NPI 1215913801
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198627200000",
    "number": "1962686022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 CHIEF RICHARD CARL SR. DRIVE",
            "city": "CRAIG",
            "state": "AK",
            "postal_code": "99921",
            "telephone_number": "907-826-2628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 KLAWOCK-HOLLIS HWY.",
            "city": "KLAWOCK",
            "state": "AK",
            "postal_code": "99925",
            "telephone_number": "907-755-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STICKWAN",
        "first_name": "MARVIN",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-26",
        "last_updated": "2007-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AK",
            "license": "27807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South East Alaska Regional Health Consortium (SEARHC Alicia Roberts Dental Clinic)
• South East Alaska Regional Health Consortium (Alicia Roberts Medical Center)
• Southeast Alaska Regional Health Consortium (SEARHC - Alicia Roberts Medical Center Pharmacy)
• Southeast Alaska Regional Health Consortium (SEARHC ARMC Behavioral Health)
• Southeast Alaska Regional Health Constortium (SEARHC Opioid Treatment Clinic-Klawock)
• Keilani Lorrainne Stockton
• Julie Ann Sturtevant, R.N.
• Jennie Taylor, APRN, PMHNP-BC
• Di Ann Thain, RDH
• Sean Fred Tomkinson, LCSW

• Registered Nurse in Klawock, AK
• Providers in Klawock, AK by specialty
• Registered Nurse in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.