| NPI | 1184054546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY MARIE BURGESS Nurse Practitioner 541-504-7781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2013-11-22 |
| Last Update Date | 2013-12-06 |