Individual
DIANA LYNN STANFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
36 SW NYE ST, NEWPORT, OR 97365-3821
(541) 265-4947
Mailing address
36 SW NYE ST, NEWPORT, OR 97365-3821
(541) 265-4947
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
082010364LPN
OR
Other
Enumeration date
11/17/2023
Last updated
11/17/2023
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