Provider Demographics
NPI:1700904091
Name:T'JOENS, CARMEN (PA)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:T'JOENS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3841 PIPER ST
Mailing Address - Street 2:STE T4-020
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4624
Mailing Address - Country:US
Mailing Address - Phone:907-646-8500
Mailing Address - Fax:907-646-9760
Practice Address - Street 1:3841 PIPER ST
Practice Address - Street 2:STE T4-020
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4624
Practice Address - Country:US
Practice Address - Phone:907-646-8500
Practice Address - Fax:907-646-9760
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK738363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK738OtherAK LICENSE