Provider Demographics
NPI:1760694939
Name:DEANNA BOOK BOESEN MD PC
Entity Type:Organization
Organization Name:DEANNA BOOK BOESEN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:BOOK
Authorized Official - Last Name:BOESEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:515-225-6044
Mailing Address - Street 1:3408 WOODLAND AVE
Mailing Address - Street 2:SUITE 502
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-6506
Mailing Address - Country:US
Mailing Address - Phone:515-225-6044
Mailing Address - Fax:515-327-5995
Practice Address - Street 1:3408 WOODLAND AVE
Practice Address - Street 2:SUITE 502
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-6506
Practice Address - Country:US
Practice Address - Phone:515-225-6044
Practice Address - Fax:515-327-5995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA256012084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA07281OtherWELLMARK BLUE CROSS BLUE