Individual
JACKELYN ERWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDM
Contact information
Practice address
2650 BROADVIEW AVE, WASILLA, AK 99654-8302
(907) 373-3420
(907) 376-7847
Mailing address
2650 BROADVIEW AVE, WASILLA, AK 99654-8302
(907) 373-3420
(907) 376-7847
Taxonomy
Speciality
Code
Description
License number
State
175M00000X
Lay Midwife
Primary
52
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52
STATE LICENSE
AK
05
—
NM3943
—
AK
Enumeration date
06/18/2007
Last updated
07/08/2007
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