Individual
DEBRA STANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
607 FAIRVIEW ST, ASHLAND, OR 97520-2917
(541) 951-8752
Mailing address
607 FAIRVIEW ST, ASHLAND, OR 97520-2917
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
200230357LPN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200230357LPN
LICENSED PRACTICAL NURSE
OR
Enumeration date
07/09/2010
Last updated
07/09/2010
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