Individual
KATRINA NUSSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
91955 DEADWOOD CREEK RD, DEADWOOD, OR 97430-9704
(541) 525-2468
Mailing address
PO BOX 104, DEADWOOD, OR 97430-0104
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
98000486RN
OR
163WC1500X
Community Health Registered Nurse
Primary
098000486RN
OR
Other
Enumeration date
03/17/2008
Last updated
08/25/2009
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