Organization
MOONRISE MIDWIFERY AND WOMEN'S HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEREDITH M WALLIS CNM, ANP (OWNER)
(505) 681-7769
Entity
Organization
Contact information
Practice address
822 BASIN RD, JUNEAU, AK 99801-1037
(505) 681-7769
(877) 299-7953
Mailing address
822 BASIN RD, JUNEAU, AK 99801-1037
(505) 681-7769
(877) 299-7953
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
1003461
AK
Other
Enumeration date
08/16/2014
Last updated
08/16/2014
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