Individual
BILLY JUNIOR NESIBA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1201 MCLEAN BLVD, EUGENE, OR 97405-1979
(541) 683-2155
Mailing address
5519 CARDIFF ST, EUGENE, OR 97402-7549
(308) 379-0213
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201910360LPN
OR
Other
Enumeration date
09/17/2020
Last updated
09/17/2020
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