Individual
MARY ANNE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
319 EAGLE RUN LOOP, BOX 215, SELDOVIA, AK 99663-0215
(907) 234-7510
Mailing address
PO BOX 215, SELDOVIA, AK 99663-0215
(907) 234-7510
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
08175-0038
AK
Other
Enumeration date
10/06/2005
Last updated
09/29/2009
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