Individual
JACI MARIE MASTRANDREA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
2610 UHRMANN RD, KLAMATH FALLS, OR 97601-1123
(541) 274-4800
Mailing address
5228 S ETNA ST, KLAMATH FALLS, OR 97603-8561
Taxonomy
Speciality
Code
Description
License number
State
163WX0200X
Oncology Registered Nurse
831838
OR
363L00000X
Nurse Practitioner
10002157
OR
363LF0000X
Family Nurse Practitioner
Primary
10002157
OR
Other
Enumeration date
12/12/2022
Last updated
03/10/2023
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