Individual
MRS. LAURIE LEIGH CALLAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP-BC
Contact information
Practice address
940 ROYAL AVE UNIT 350, MEDFORD, OR 97504-6194
(541) 732-7460
(541) 734-7461
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(541) 734-7460
(541) 732-7461
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
095006655
OR
363LF0000X
Family Nurse Practitioner
Primary
200650147NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292038
—
OR
Enumeration date
09/14/2006
Last updated
10/13/2020
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