Most Relevant Information
Provider Data
| NPI Number: | 1003352832 |
| Provider Name: | NICOLE BRASHEARS PA-C, ATC |
| Entity Type: | Individual |
| Taxonomy Code: | 171000000X |
| Specialty: | Military Health Care Provider |
| License Number: | 1220918 |
Most Important Dates
| Enumeration Date: | 01/18/2017 |
| Last Updated: | 07/03/2024 |
Provider Practice Location
BLDG #50, FARENHOLT AVE, AGANA HEIGHTS
FPO
AP
96910
Practice Location Phone/Fax
| Phone: | 6713449340 |
| Fax: |
Provider Mailing Location
2305 PHEASANT RUN CIR
GRAND JUNCTION
CO
815064877
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |