Individual
DELLA FOGERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
36 SW NYE ST, NEWPORT, OR 97365-3821
(541) 265-4179
Mailing address
36 SW NYE ST, NEWPORT, OR 97365-3821
(541) 265-4179
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
OR
Other
Enumeration date
04/10/2007
Last updated
11/19/2007
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