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Individual

MS. AIMEE KODIAQ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
913 NW GARDEN VALLEY BLVD, ROSEBURG, OR 97471-6523
(541) 440-1000
Mailing address
1212 N 10TH ST APT B, COOS BAY, OR 97420-1981
(503) 575-8941

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
20075D066NP
OR
363LF0000X
Family Nurse Practitioner
4984
CO

Other

Enumeration date
02/23/2007
Last updated
11/18/2023
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