Individual
HANNAH PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
215 MOBILE DR, ASHLAND, OR 97520-9021
(541) 282-3603
Mailing address
455 DRAGER ST, ASHLAND, OR 97520-1102
(608) 632-1784
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201240056RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GU401B6H
—
OR
Enumeration date
02/23/2012
Last updated
02/23/2012
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