Individual
MR. MICAH A WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1001 S KNIK GOOSE BAY RD, WASILLA, AK 99654-8083
(907) 631-7800
Mailing address
7033 E TUDOR RD, ANCHORAGE, AK 99507-1262
(907) 729-9989
(907) 729-5180
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
104271
AK
Other
Enumeration date
09/20/2007
Last updated
02/24/2025
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