Provider Demographics
NPI:1225317316
Name:STROMMER, ANGELA JANE
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:JANE
Last Name:STROMMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 W 7TH AVE STE 1800
Mailing Address - Street 2:STATE OF ALASKA DEPARTMENT OF CORRECTIONS
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3569
Mailing Address - Country:US
Mailing Address - Phone:907-744-5598
Mailing Address - Fax:
Practice Address - Street 1:550 W 7TH AVE STE 1800
Practice Address - Street 2:STATE OF ALASKA DEPARTMENT OF CORRECTIONS
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3569
Practice Address - Country:US
Practice Address - Phone:907-744-5598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1234363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKP01123480OtherMEDICARE RAILROAD
AK1574780Medicaid
AKP01123480OtherMEDICARE RAILROAD