Healthcare Provider Details

I. General information

NPI: 1073636593
Provider Name (Legal Business Name): ARLENE GALE JORGENSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3245 HOSPITAL DR SEARHC JUNEAU MEDICAL CLINIC
JUNEAU AK
99801
US

IV. Provider business mailing address

11584 MENDENHALL LOOP RD
JUNEAU AK
99801-8603
US

V. Phone/Fax

Practice location:
  • Phone: 907-463-6610
  • Fax: 907-463-6695
Mailing address:
  • Phone: 907-789-9843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0600X
TaxonomyInfection Control Registered Nurse
License Number19477
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: