Individual
LISA M COONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1751 E GARDNER WAY, SUITE E, WASILLA, AK 99654
(907) 376-1633
(907) 376-7864
Mailing address
1751 E GARDNER WAY, SUITE E, WASILLA, AK 99654
(907) 376-1633
(907) 376-7864
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
3925
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD3925
—
AK
Enumeration date
03/18/2006
Last updated
02/14/2013
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