Individual
BROOKE VANESSA CORDOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1001 NOBLE ST STE 1, FAIRBANKS, AK 99701-4991
(907) 459-3520
(907) 459-3541
Mailing address
PO BOX 73720, FAIRBANKS, AK 99707-3720
(814) 594-1319
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
164786
AK
363A00000X
Physician Assistant
PA9106366
FL
Other
Enumeration date
12/09/2011
Last updated
07/02/2021
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