Organization
RIVER ROCK FAMILY PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY HARRISON (SECRETARY)
(541) 226-9840
Entity
Organization
Contact information
Practice address
1833 NEBRASKA AVE, GRANTS PASS, OR 97527-5701
(541) 621-4736
Mailing address
1833 NEBRASKA AVE, GRANTS PASS, OR 97527-5701
(541) 226-9840
(541) 226-9846
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200550153NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026845
DMAP
—
01
—
1356355846
NPI INDIVIDUAL
—
01
—
200550153NP
FNPC
OR
Enumeration date
10/29/2013
Last updated
03/07/2023
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