Individual
SARA LYNN BRAKEBUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1750 THOMPSON RD, COOS BAY, OR 97420-2100
(541) 266-4402
Mailing address
1750 THOMPSON RD, COOS BAY, OR 97420-2100
(541) 266-4402
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
200850111NP
OR
Other
Enumeration date
08/22/2008
Last updated
08/22/2008
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