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Individual

KAIA KORDOSKY-HERRERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
269 S CANDY LN, COTTONWOOD, AZ 86326-4158
(602) 290-4504
(928) 639-6059
Mailing address
6362 W BEHREND DR, GLENDALE, AZ 85308-7012

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4294
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1083720
NCCPA ID
Enumeration date
10/13/2008
Last updated
10/13/2008
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