MARY ANNE WILSON (NPI# 1790773570) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790773570 |
| Entity Type | Individual |
| Full Name | MARY ANNE WILSON |
| Credential | ANP |
| Practice Address |
319 Eagle Run Loop Box 215 Seldovia AK 99663-0215 |
| Mailing Address |
Po Box 215 Seldovia AK 99663-0215 |
| Practice Telephone | 9072347510 |
| Mailing Telephone | 9072347510 |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2009-09-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
08175-0038 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
319 EAGLE RUN LOOP BOX 215 |
| City | SELDOVIA |
| State | AK |
| Zip Code | 99663-0215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184174831 | Community Health Imaging Centers | Clinic/Center | 259 Seldovia Street, Seldovia, AK 99663 | 2016-10-06 |
| 1699166215 | Alison Godwin | Massage Therapist | 206 Main Street, Seldovia, AK 99663 | 2015-02-18 |
| 1912301110 | La Maestra Family Clinic, Inc. | Physician Assistant | 259 Seldovia Street, Box 206, Seldovia, AK 99663-0206 | 2014-10-16 |
| 1417020348 | Lawrence Lewis Reynolds | General Practice | 252 Seldovia St, Seldovia, AK 99663-0210 | 2006-11-16 |
| 1487989117 | Lilli Ann Ohse | Counselor | Po Box L, Seldovia, AK 99663-0250 | 2009-10-14 |
| 1093272148 | Melissa R Peterson | Dental Hygienist | Po Box L, Seldovia, AK 99663-0250 | 2019-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184174831 | Community Health Imaging Centers | Clinic/Center | 259 Seldovia Street, Seldovia, AK 99663 | 2016-10-06 |
| 1912301110 | La Maestra Family Clinic, Inc. | Physician Assistant | 259 Seldovia Street, Box 206, Seldovia, AK 99663-0206 | 2014-10-16 |
| 1487989117 | Lilli Ann Ohse | Counselor | Po Box L, Seldovia, AK 99663-0250 | 2009-10-14 |
| 1417020348 | Lawrence Lewis Reynolds | General Practice | 252 Seldovia St, Seldovia, AK 99663-0210 | 2006-11-16 |
| 1093272148 | Melissa R Peterson | Dental Hygienist | Po Box L, Seldovia, AK 99663-0250 | 2019-02-25 |
| 1699166215 | Alison Godwin | Massage Therapist | 206 Main Street, Seldovia, AK 99663 | 2015-02-18 |
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355390 | Delia M. Reyes | Nurse Practitioner | 705 2nd St., Cordova, AK 99574 | 2020-10-29 |
| 1396342895 | Stacey Reynolds Dahl | Nurse Practitioner | 103 Fram Treet, Petersburg, AK 99833-0589 | 2020-10-07 |
| 1912514647 | Kaveri Bharti | Nurse Practitioner | 2900 Morgan Loop, Anchorage, AK 99516-1427 | 2020-09-27 |
| 1831709070 | China Kay Larson | Nurse Practitioner | 9402 Endicott St, Anchorage, AK 99502-1342 | 2020-08-03 |
| 1144847021 | Stephanie Anne Olah Packard | Nurse Practitioner | 6929 Crawford St, Anchorage, AK 99502-2728 | 2020-06-26 |
| 1134743370 | Matthew G Horgan | Nurse Practitioner | 700 Chief Eddie Hoffman Hwy, Bethel, AK 99559-0827 | 2020-06-03 |
| 1417585902 | Shelley Wantaja | Nurse Practitioner | 689 E Eklutna St, Palmer, AK 99645-6116 | 2020-03-30 |
| 1437787363 | Naomi Tonje Johnson | Nurse Practitioner | 5428 E Rebecca Nicole St Unit C, Wasilla, AK 99654-0002 | 2020-03-27 |
| 1235789322 | Halley Marie Fondren | Nurse Practitioner | Page Street, Soldotna, AK 99669-2634 | 2019-09-19 |
| 1710535380 | Peter Harvey | Nurse Practitioner | 755 Knightsbridge Rd, Fairbanks, AK 99709-2477 | 2019-08-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.