Individual
EILEEN M TABERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
544 W UMPQUA ST, ROSEBURG, OR 97470
(541) 672-9596
(541) 464-3519
Mailing address
544 W UMPQUA ST, ROSEBURG, OR 97470
(541) 672-9596
(541) 464-3519
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168395
—
OR
01
—
R03163
MEDICARE PART B
—
Enumeration date
10/04/2006
Last updated
04/11/2008
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