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Individual

MRS. OLIVIA JEAN WALL PETRIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1130 LINDBLAD AVE, GIRDWOOD, AK 99587
(907) 783-1355
(907) 783-1357
Mailing address
PO BOX 1130, GIRDWOOD, AK 99587-1130
(907) 783-1355
(907) 783-1357

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PADA1224
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1626495
AK
Enumeration date
12/23/2014
Last updated
03/04/2026
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