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Individual

MELISSA WILLEMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
709 E 76TH AVE, 1, ANCHORAGE, AK 99518-2849
(907) 202-3379
(907) 644-0790
Mailing address
709 E 76TH AVE, 1, ANCHORAGE, AK 99518-2849
(907) 202-3379
(907) 644-0790

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
1624023
AK
171M00000X
Case Manager/Care Coordinator
Primary
1629601
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1624023
AK
05
1629601
AK
Enumeration date
12/20/2014
Last updated
04/22/2016
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