| Alyssa Prollock, RD | |
|
1640 Cowles St, Fairbanks, AK 99701-5908 | |
| (907) 458-5629 | |
| Not Available |
| Full Name | Alyssa Prollock |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered - Nutrition, Oncology |
| Location | 1640 Cowles St, Fairbanks, Alaska |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215614409 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133VN1301X | Dietitian, Registered - Nutrition, Oncology | 208636 (Alaska) | Primary |
| Provider Name | Tanana Valley Clinic LLC |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1922559558 PECOS PAC ID: 5698056901 Enrollment ID: O20161228001991 |
| Mailing Address | Practice Location Address |
|---|---|
| Alyssa Prollock, RD 3981 Buckeye Ln Apt 1, Fort Wainwright, AK 99703-1609 Ph: (404) 414-5431 | Alyssa Prollock, RD 1640 Cowles St, Fairbanks, AK 99701-5908 Ph: (907) 458-5629 |
Anne Burtness, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1717 W Cowles St, Fairbanks, AK 99701 Phone: 907-451-6682 Fax: 907-459-3811 |
Mrs. Cindy Jane Salmon, RD Dietitian Medicare: Accepting Medicare Assignments Practice Location: 828 Crossman Rd, Fairbanks, AK 99712 Phone: 907-457-6688 Fax: 907-782-4232 |
Ellen Elizabeth Mcewen, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 605 Chief Thomas Dr, Fairbanks, AK 99709 Phone: 907-615-8142 |
Nutrawellness Works, Inc Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1400 Blackberry Dr, Fairbanks, AK 99712 Phone: 907-699-7799 Fax: 907-459-8201 |
Alcan Medical Group Llc Dietitian Medicare: Medicare Enrolled Practice Location: 751 Old Richardson Hwy Ste 203, Fairbanks, AK 99701 Phone: 303-472-6424 |
Laurie Jeanne Struthers, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1919 Lathrop Street, Suite 122, Fairbanks, AK 99701 Phone: 907-458-6400 Fax: 907-458-6405 |
Shelby A Braun, MS, RDN, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1001 Noble St, Fairbanks, AK 99701 Phone: 907-459-3500 Fax: 907-459-3526 |