Individual
NICOLE ANNE KANDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4076 NEELY RD, FORT WAINWRIGHT, AK 99703
(907) 361-5172
Mailing address
5623 MASON LN, KLAMATH FALLS, OR 97601-9379
(541) 591-4719
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
251
HI
2255A2300X
Athletic Trainer
Primary
251410
AK
2255A2300X
Athletic Trainer
A160804654
WA
2255A2300X
Athletic Trainer
AT-AT-10197732
OR
Other
Enumeration date
09/25/2015
Last updated
04/08/2026
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