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Individual

MS. KATIE L WELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CFNP

Contact information

Practice address
603 MEDICAL PKWY, ENTERPRISE, OR 97828-5124
(541) 426-7900
(541) 426-7901
Mailing address
601 MEDICAL PKWY, ENTERPRISE, OR 97828-5124
(541) 426-7900
(541) 426-7901

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP741A
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
807425100
ID
Enumeration date
05/12/2006
Last updated
04/27/2022
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