Unknown Individual – Family Nurse Practitioner, NPI 1013971340
Family Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
21990, Crater Lake Highway, Shady Cove, Jackson County, Oregon, 97539, United States
SHADY COVE, OR 975399717
Phone: (541) 878-2022
Fax: (541) 878-1498
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97539)
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