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PAULINE WILSON
>> Community Health Worker >> Other Service ProvidersRegistrant NPI Number: 1609322924
Individual Registrant: PAULINE WILSON
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
128 FRONT STREET SCAMMON BAY, AK 99662-0150 US
Tel: 907-758-4711 Fax: 907-758-3540
Tel: 907-758-4711 Fax: 907-758-3540
Contact information for business:
128 FRONT STREET SCAMMON BAY, AK 99662-0150 US
Tel: 907-558-5511 Fax: 907-558-5705
Tel: 907-558-5511 Fax: 907-558-5705
Registration Information:
NPI: 1609322924
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 172V00000X | Other Service Providers Community Health Worker |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
