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Individual

ROBERTA A KAISER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
312 E MAIN ST, TALENT, OR 97540-9752
(541) 535-9108
Mailing address
PO BOX 422, TALENT, OR 97540-0422
(541) 535-9108

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
00039271
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002052000
REGENCE BC
OR
05
077701
OR
01
ROOOOXCBBF
MEDICARE
OR
Enumeration date
10/11/2006
Last updated
05/19/2008
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