Individual
MAYRA ELAINE DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6051
(541) 382-4900
Mailing address
PO BOX 670, BEND, OR 97709-0670
(541) 389-7741
(541) 278-8375
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200250060NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000627
OMAP PERFORMING PROVIDER
OR
05
—
000627
—
OR
Enumeration date
01/08/2006
Last updated
07/27/2024
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