Individual
JESSICA LANEICE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BHRN
Contact information
Practice address
3851 PIPER ST STE U464, ANCHORAGE, AK 99508-6905
(907) 339-0363
(907) 339-2363
Mailing address
7033 E TUDOR RD, ANCHORAGE, AK 99507-1262
(907) 729-8901
(907) 729-6353
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
117979
AK
363LF0000X
Family Nurse Practitioner
Primary
236190
AK
Other
Enumeration date
11/02/2022
Last updated
04/05/2025
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