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1001 E Bogard Rd, Wasilla, AK 99654-7114 | |
(907) 376-2225 | |
(907) 376-9225 |
Full Name | |
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Type | Facility |
Speciality | Family Medicine |
Location | 1001 E Bogard Rd, Wasilla, Alaska |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1053690677 | NPI | - | NPPES |
Provider Name | Patricia G Johnson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1750441820 PECOS PAC ID: 2769478999 Enrollment ID: I20040428001145 |
Provider Name | Melanie Kimmery |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366548877 PECOS PAC ID: 6901822915 Enrollment ID: I20051019000666 |
Mailing Address | Practice Location Address |
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1001 E Bogard Rd, Wasilla, AK 99654-7114 Ph: (907) 376-2225 | 1001 E Bogard Rd, Wasilla, AK 99654-7114 Ph: (907) 376-2225 |