Provider Demographics
NPI:1366782609
Name:SPRENGER, WANDA ANN (PMH-NP)
Entity type:Individual
Prefix:
First Name:WANDA
Middle Name:ANN
Last Name:SPRENGER
Suffix:
Gender:F
Credentials:PMH-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 E WESTPOINT DR STE 302
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7183
Mailing Address - Country:US
Mailing Address - Phone:907-373-5015
Mailing Address - Fax:907-631-0962
Practice Address - Street 1:851 E WESTPOINT DR STE 302
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7183
Practice Address - Country:US
Practice Address - Phone:907-373-5015
Practice Address - Fax:907-631-0962
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-24
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK167673363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health