Individual
SUSAN HOMOLKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1670 HIGH ST, EUGENE, OR 97401-4151
(541) 344-9411
Mailing address
3456 OLYMPIC ST, SPRINGFIELD, OR 97478-5574
(541) 729-7774
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
200350028NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292793
—
OR
Enumeration date
01/31/2007
Last updated
07/20/2009
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