| Desiree Dawn Cook, CPNP-PC, PMHNP | |
|
3750 E. Country Field Circle, Suite C, Wasilla, AK 99654 | |
| (907) 357-2955 | |
| (907) 357-9348 |
| Full Name | Desiree Dawn Cook |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Pediatrics |
| Location | 3750 E. Country Field Circle, Wasilla, Alaska |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831602341 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LP0200X | Nurse Practitioner - Pediatrics | 126978 (Alaska) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 2023001598 (Alaska) | Secondary |
| Entity Name | Ketamine Wellness Institute, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740066216 PECOS PAC ID: 4789038928 Enrollment ID: O20230921003948 |
| Mailing Address | Practice Location Address |
|---|---|
| Desiree Dawn Cook, CPNP-PC, PMHNP 3505 E Meridian Park Loop Ste 200, Wasilla, AK 99654-7242 Ph: (907) 357-4400 | Desiree Dawn Cook, CPNP-PC, PMHNP 3750 E. Country Field Circle, Suite C, Wasilla, AK 99654 Ph: (907) 357-2955 |
Alysa Sonnentag, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 211 E Fairview Loop, Wasilla, AK 99654 Phone: 907-373-3335 | |
Ms. Lisa Bouyea-francies, APRN-FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1363 W Spruce Ave, Wasilla, AK 99654 Phone: 907-376-2411 Fax: 907-352-3373 | |
Stephanie Rae Mcquillin, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1751 E Gardner Way Ste E, Wasilla, AK 99654 Phone: 907-376-9321 Fax: 907-376-9322 | |
James Hales, FNP-C. FNP-BC, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1001 S Knik Goose Bay Rd, Wasilla, AK 99654 Phone: 907-631-7800 | |
Mr. Clinton Deaver, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 7010 E Bogard Rd, Wasilla, AK 99654 Phone: 907-373-4732 | |
Randall Twenhafel, PNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 950 E Bogard Rd Ste 233, Wasilla, AK 99654 Phone: 907-357-4543 Fax: 907-357-4533 | |
Samantha Lyn Hamilton, NP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3190 E Meridian Park Loop, Wasilla, AK 99654 Phone: 907-373-9460 |