Provider Demographics
NPI:1265679401
Name:COOLIDGE, DEBORAH LENA (PA-C)
Entity Type:Individual
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First Name:DEBORAH
Middle Name:LENA
Last Name:COOLIDGE
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:3122 E MERIDIAN PARK LOOP
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7255
Mailing Address - Country:US
Mailing Address - Phone:907-864-4625
Mailing Address - Fax:907-313-1540
Practice Address - Street 1:501 1ST STREET
Practice Address - Street 2:
Practice Address - City:PRUDHOE BAY
Practice Address - State:AK
Practice Address - Zip Code:99734
Practice Address - Country:US
Practice Address - Phone:907-685-1725
Practice Address - Fax:907-357-9593
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2023-11-29
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant