Individual
MRS. TRACEY L WIESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
7501 ROVENNA ST UNIT A, ANCHORAGE, AK 99518-2650
(907) 793-0686
(726) 232-5849
Mailing address
7501 ROVENNA ST UNIT A, ANCHORAGE, AK 99518-2650
(907) 793-0686
(726) 232-5849
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1121
AK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1121
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022312
—
AK
05
—
MPG0335
—
AK
05
—
NP0101
—
AK
Enumeration date
12/10/2009
Last updated
05/07/2026
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