Organization
LIVING WELL MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY RAE KREGER NURSE PRACTITIONER (NP/OWNER)
(541) 813-1505
Entity
Organization
Contact information
Practice address
524 SPRUCE ST STE 5, BROOKINGS, OR 97415-0407
(541) 813-1505
(541) 813-1506
Mailing address
PO BOX 488, BROOKINGS, OR 97415-0043
(541) 813-1505
(541) 813-1506
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/07/2023
Last updated
02/08/2024
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