Individual
ANNA DELAINE DODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
110 10TH ST SE, BANDON, OR 97411-9157
(541) 347-5191
(541) 347-2015
Mailing address
110 10TH ST SE, BANDON, OR 97411-9157
(541) 347-5191
(541) 347-2015
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201811350NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500760099
—
OR
Enumeration date
01/16/2019
Last updated
06/27/2022
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