Individual
GAYLENE LYDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNFA
Contact information
Practice address
2801 NW MERCY DR, SUITE 330, ROSEBURG, OR 97471-2348
(541) 677-3600
(541) 677-3601
Mailing address
2750 W HARVARD AVE, ROSEBURG, OR 97471-2608
(541) 673-8988
(541) 672-8103
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
80012252
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090461
—
OR
Enumeration date
07/14/2006
Last updated
07/03/2008
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