Provider Demographics
NPI:1275935231
Name:NABONG, JULIEANNLOU
Entity Type:Individual
Prefix:
First Name:JULIEANNLOU
Middle Name:
Last Name:NABONG
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 1:2632 BROOKSTONE LOOP
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-2709
Mailing Address - Country:US
Mailing Address - Phone:907-602-2416
Mailing Address - Fax:
Practice Address - Street 1:2632 BROOKSTONE LOOP
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-2709
Practice Address - Country:US
Practice Address - Phone:907-602-2416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-22
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK6954164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse