Healthcare Provider Details

I. General information

NPI: 1104034552
Provider Name (Legal Business Name): DEANNA BOOK BOESEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEANNA BOOK M.D.

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 SW 9TH ST STE 2
DES MOINES IA
50315-6138
US

IV. Provider business mailing address

PO BOX 1475
DES MOINES IA
50305-1475
US

V. Phone/Fax

Practice location:
  • Phone: 515-643-9030
  • Fax: 515-643-9031
Mailing address:
  • Phone: 515-643-9030
  • Fax: 515-643-9031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD-25601
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD-25601
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: