Individual
NICOLE ROSE LA BOMBARDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1000 GREG KRUSCHEK AVENUE, NOME, AK 99762
(907) 443-3311
Mailing address
PO BOX 1550, NOME, AK 99762-1550
(907) 443-3504
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130061000
—
MD
Enumeration date
03/05/2009
Last updated
06/30/2022
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