Individual
CARLY POLICHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1435 G ST, SPRINGFIELD, OR 97477-4113
(541) 735-9420
Mailing address
1435 G ST, SPRINGFIELD, OR 97477-4113
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10046050
OR
Other
Enumeration date
07/07/2025
Last updated
07/07/2025
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