Individual
JOANNA OLIVER WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP-C
Contact information
Practice address
206 W ROCKWELL AVE, #100, SOLDOTNA, AK 99669-7439
(907) 262-7566
Mailing address
206 W ROCKWELL AVE, #100, SOLDOTNA, AK 99669-7439
(907) 262-7566
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
117672
AK
163W00000X
Registered Nurse
R888969
MS
363LF0000X
Family Nurse Practitioner
Primary
117654
AK
363LF0000X
Family Nurse Practitioner
901842
MS
Other
Enumeration date
12/05/2016
Last updated
12/05/2016
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