Individual
CORRIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1025 BARNETTE STREET, FAIRBANKS, AK 99701
(907) 452-1776
Mailing address
PO BOX 56257, NORTH POLE, AK 99705-1257
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
128479
AK
Other
Enumeration date
05/15/2018
Last updated
05/15/2018
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