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NPI Code Detail

MEDICARE: JONI STAMM

MEDICARE: JONI STAMM
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
1171M00000XCase Manager/Care Coordinator

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184993610
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONI STAMM
Provider Business Mailing Address
First Line : 1825 MARIKA RD
Second Line :
City : FAIRBANKS
State : AK
Zip : 99709-5521
Country : US
Telephone Number : 907-474-0890
Fax Number : 907-474-3621
Provider Business Practice Location Address
First Line : 1423 PEGER RD
Second Line :
City : FAIRBANKS
State : AK
Zip : 99709-5169
Country : US
Telephone Number : 907-456-7010
Fax Number : 907-456-7017
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2011
Last Update Date : 12/29/2011

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Directions to “ JONI STAMM ” Practice Location

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