Individual
ANGELINA LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP
Contact information
Practice address
495 SW RAMSEY AVE, GRANTS PASS, OR 97527
(541) 476-6644
(541) 472-5673
Mailing address
495 SW RAMSEY AVE, GRANTS PASS, OR 97527
(541) 476-6644
(541) 472-5673
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
091007741N1
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039052
—
OR
Enumeration date
06/23/2005
Last updated
01/13/2025
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