Organization
LAURIE L CALLAHAN, FNP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURIE LEIGH CALLAHAN MSN, FNP-BC, RNFA (PRESIDENT)
(541) 659-0969
Entity
Organization
Contact information
Practice address
6086 E EVANS CREEK RD, ROGUE RIVER, OR 97537-9642
(541) 659-0969
Mailing address
6086 E EVANS CREEK RD, ROGUE RIVER, OR 97537-9642
(541) 659-0969
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
095006655
OR
363LF0000X
Family Nurse Practitioner
Primary
200650147NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500618438
DMAP
OR
Enumeration date
01/26/2007
Last updated
10/29/2018
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