Individual
MS. KERRY KILGORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RNFA
Contact information
Practice address
525 N SANTIAM HWY, LEBANON, OR 97355-4363
(541) 258-2101
Mailing address
PO BOX 1193, CORVALLIS, OR 97339-1193
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
200241497RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200241497RN
OREGON BOARD OF NURSING
OR
Enumeration date
08/22/2011
Last updated
01/14/2021
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