Individual
ANJELA KELLI WILMOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1535 PORCHET WAY APT C, FAIRBANKS, AK 99709-4086
(907) 707-9943
Mailing address
1535 PORCHET WAY APT C, FAIRBANKS, AK 99709-4086
(907) 707-9943
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
7184134
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7184134
—
AK
Enumeration date
08/02/2022
Last updated
08/02/2022
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