Van Wulven, Jessica D

Van Wulven, Jessica D is an individual health care provider with primary practice located at 3765 E. Blue Lupine Dr. Ste D , Wasilla AK 99654. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Van Wulven, Jessica D can be contacted via phone (907) 707-1671.

Contact Information

Primary practice address
3765 E. Blue Lupine Dr. Ste D Wasilla AK 99654
Phone: (907) 707-1671
Fax: (907) 707-1675
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 2365 Alaska
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PADA1218 Alaska

Profile Details

NPI number 1457758815
LBN Legal business name Van Wulven, Jessica D
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 1st, 2014
Last updated Feb 2nd, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457758815 NPPES
Alaska MEDICAID 1648921

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