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Wade Bror Clauson, LPN

Licensed Practical Nurse in Jber, AK. Individual provider (NPI-1).

NPI number1821363532
StatusActive
Last updated in NPPESMar 13, 2012

Details

NPI
1821363532
Entity type
Individual (NPI-1)
Name
Wade Bror Clauson
Credential
LPN
Sex
Male
Sole proprietor
No
Enumeration date
Mar 13, 2012
Last updated
Mar 13, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
164W00000X Licensed Practical Nurse6820AKYes
146N00000X Emergency Medical Technician, BasicEMT530361FL
164W00000X Licensed Practical NursePN5199765FL

Practice location

7411 Metzger Ave Unit B
Jber, AK 99506-2022

Phone 907-330-9779

Mailing address

7411 Metzger Ave Unit B
Jber, AK 99506

Phone 907-330-9779

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