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1598508640
CARMELLA L FULLENWIDER
REDMOND, OR
NPI
1598508640
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP2300X Nurse Practitioner, Primary Care
(Licence: OR 10027848)
Enumeration Date
2024-06-17
Last Update Date
2024-06-28
Business Address
CARMELLA L FULLENWIDER AG-PCNP-BC
645 NW 4TH ST
REDMOND, OR 97756-1502
Phone number: 541-389-7741
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Mailing Address
CARMELLA L FULLENWIDER AG-PCNP-BC
PO BOX 1517
PENDLETON, OR 97801-0410
Phone number: 541-278-4332
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