Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 113274 | AK |
NPI | 1144545476 |
---|---|
Provider Name | Jessie Willow Janowski |
First Address | Anchorage, AK 99508-5926 |
Second Address | Anchorage, AK 99508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2010 |
Last Update Date | 28/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1652811 | (05) | AK |