Individual
MAREENA MICHELLE BECERRIL-WILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4219 S PINNACLE PEAK DR, WASILLA, AK 99623-0721
(907) 521-5543
Mailing address
4219 S PINNACLE PEAK DR, WASILLA, AK 99623-0721
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
NURP6825
AK
Other
Enumeration date
09/26/2017
Last updated
09/26/2017
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