Individual provider · Type 1 NPI

Leilani Carol Disselkoen

Student in an Organized Health Care Education/Training Program · Wasilla, AK

NPI number 1245102417 Active

Practice location

7010 E Bogard Rd
Wasilla, AK 99654-4711

Call (907) 373-4732 Map

Mailing address

17641 Beaujolais Dr
Eagle River, AK 99577-7515

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1245102417

Leilani Carol Disselkoen's National Provider Identifier is 1245102417, issued on Sep 18, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Wasilla, AK. The record was last updated on Sep 18, 2025.