Individual
LENA MARIE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
670 W FIREWEED LN STE 160, ANCHORAGE, AK 99503-2561
(907) 770-0862
Mailing address
5457 NEW SMYRNA CIR, ANCHORAGE, AK 99508-2577
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
148117
AK
Other
Enumeration date
06/13/2019
Last updated
08/23/2019
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