Unknown Individual – Nurse Practitioner, NPI 1104914563
Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Bend Post Office, 2300, Northeast 4th Street, Orchard District, Bend, Deschutes County, Oregon, 97701, United States
BEND, OR 977085579
Phone: (541) 526-6635
Fax: (541) 526-6636
Type: Mailing
340, Northwest 5th Street, Redmond, Deschutes County, Oregon, 97756, United States
SUITE 101
REDMOND, OR 977561869
Phone: (541) 526-6635
Fax: (541) 526-6636
Type: Location
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
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97708)
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