Individual
NICA ELENA LURTSEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6051
(541) 382-4900
Mailing address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6051
(541) 382-4900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD218776
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500837469
—
OR
Enumeration date
04/14/2021
Last updated
10/05/2024
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