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NPI Code Detail

MEDICARE: JESSCIA DENAE SMOTHERMON

MEDICARE: JESSCIA DENAE SMOTHERMON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374700000XTechnician

General Provider Information

NPI Number : 1174897011
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSCIA DENAE SMOTHERMON
Provider Business Mailing Address
First Line : 1058 W 27TH AVE
Second Line :
City : ANCHORAGE
State : AK
Zip : 99503-2424
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1058 W 27TH AVE
Second Line :
City : ANCHORAGE
State : AK
Zip : 99503-2424
Country : US
Telephone Number : 907-274-7391
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2012
Last Update Date : 02/23/2012

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Directions to “ JESSCIA DENAE SMOTHERMON ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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