Provider Demographics
NPI:1003036500
Name:STAGELMAN, SANDY MARIE (RN)
Entity type:Individual
Prefix:
First Name:SANDY
Middle Name:MARIE
Last Name:STAGELMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:3810 MARCY CT
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-2835
Mailing Address - Country:US
Mailing Address - Phone:907-770-6224
Mailing Address - Fax:907-770-1692
Practice Address - Street 1:3101 PENLAND PKWY
Practice Address - Street 2:SUITE J11
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-1906
Practice Address - Country:US
Practice Address - Phone:907-334-8535
Practice Address - Fax:907-279-8032
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AK19568163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy