Provider Demographics
NPI:1649305798
Name:LUBATON, JOSEPHINE L (RN)
Entity type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:L
Last Name:LUBATON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 ADONIS DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-1486
Mailing Address - Country:US
Mailing Address - Phone:907-929-4819
Mailing Address - Fax:907-929-3819
Practice Address - Street 1:1720 ADONIS DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-1486
Practice Address - Country:US
Practice Address - Phone:907-929-4819
Practice Address - Fax:907-929-3819
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100540310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility