Individual
MRS. JAMIE KERSENBROCK BARBARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC, RN, BSN
Contact information
Practice address
5200 MEADOWS RD, SUITE 250, LAKE OSWEGO, OR 97035-3202
(503) 445-2200
Mailing address
1010 NE SKIDMORE ST, PORTLAND, OR 97211-3476
(541) 206-2696
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201501756RN
OR
363LF0000X
Family Nurse Practitioner
Primary
201501757NP-PP
OR
Other
Enumeration date
07/09/2014
Last updated
02/01/2017
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