Individual
HEATHER KOPONEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1408 19TH AVE, FAIRBANKS, AK 99701-5903
(907) 451-6682
(907) 459-3912
Mailing address
1408 19TH AVE, FAIRBANKS, AK 99701-5903
(907) 451-6682
(907) 459-3912
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
383
AK
Other
Enumeration date
10/21/2005
Last updated
07/08/2007
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