OrganizationActive
Petaloso Inc
NPI 1982059952 · Family Nurse Practitioner · Fairbanks, AK
Provider details
- NPI number
- 1982059952
- Entity type
- Organization
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Janice Stables, President(907) 978-7721
- License
- 420 (AK)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(72/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1867 Airport Way Ste 110b
Fairbanks, AK 99701-4054
Phone: (907) 978-7721
Fax: (907) 452-6330
Street-level locationGet directions
Mailing address
1867 Airport Way Ste 110b
Fairbanks, AK 99701-4054
Other names (DBA / former)
- Doing business as
- Petaloso
Registry dates
- Enumerated
- 2016-04-27
- Last updated
- 2016-04-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.