Individual
MRS. MANDY IRENE HOLFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1745 NE KLAMATH AVE, ROSEBURG, OR 97470-2119
(541) 672-5297
(541) 672-5297
Mailing address
1745 NE KLAMATH AVE, ROSEBURG, OR 97470-2119
(541) 672-5297
(541) 672-5297
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN000006013
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPN000006013
STATE BOARD OF NURSING
OR
Enumeration date
05/03/2010
Last updated
05/03/2010
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