| NPI | 1215508411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIE R WILKS Nurse Practitioner/Owner 907-617-8485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-07-08 |
| Last Update Date | 2021-07-08 |