Individual
MS. LISA LOUISE KUETTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1700 SE TEMPEST DR, BEND, OR 97702-1884
(541) 323-3854
(541) 383-1883
Mailing address
375 NW BEAVER ST STE 101, PRINEVILLE, OR 97754-1802
(541) 447-0707
(541) 383-1883
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20055078NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140447
—
OR
Enumeration date
07/24/2006
Last updated
09/03/2015
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