Individual
DEAN ROBINS WENTWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
6645 GLENEDEN BEACH LOOP STE 1152, GLENEDEN BEACH, OR 97388
(971) 409-3985
Mailing address
PO BOX 1152, 235 LORRAINE STREET, GLENEDEN BEACH, OR 97388
(971) 409-3985
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
200750106
OR
363LA2200X
Adult Health Nurse Practitioner
75068
KS
363LF0000X
Family Nurse Practitioner
2007501060NP
OR
363LF0000X
Family Nurse Practitioner
200750106NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274493
—
OR
Enumeration date
07/23/2007
Last updated
03/01/2019
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