Provider Demographics
NPI:1609080464
Name:RASS, JUANITA EMILY (APRN-C PHD)
Entity Type:Individual
Prefix:
First Name:JUANITA
Middle Name:EMILY
Last Name:RASS
Suffix:
Gender:F
Credentials:APRN-C PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 EAGLE DRIVE # 661
Mailing Address - Street 2:
Mailing Address - City:HOONAH
Mailing Address - State:AK
Mailing Address - Zip Code:99829-0661
Mailing Address - Country:US
Mailing Address - Phone:907-209-2126
Mailing Address - Fax:
Practice Address - Street 1:5 EAGLE DRIVE # 661
Practice Address - Street 2:
Practice Address - City:HOONAH
Practice Address - State:AK
Practice Address - Zip Code:99829-0661
Practice Address - Country:US
Practice Address - Phone:907-209-2126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK631363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily