Provider Demographics
NPI:1679515761
Name:HLADICK, WENDY EILEEN (PA)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:EILEEN
Last Name:HLADICK
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 584
Mailing Address - Street 2:
Mailing Address - City:UNALASKA
Mailing Address - State:AK
Mailing Address - Zip Code:99685
Mailing Address - Country:US
Mailing Address - Phone:907-581-6563
Mailing Address - Fax:907-581-2331
Practice Address - Street 1:ILIULIUK FAMILY AND HEALTH SERVICES
Practice Address - Street 2:LAVELLE COURT
Practice Address - City:UNALASKA
Practice Address - State:AK
Practice Address - Zip Code:99685
Practice Address - Country:US
Practice Address - Phone:907-581-6563
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK225363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical