Individual
MARIA NASYBULLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
33142 CAMAS SWALE RD, CRESWELL, OR 97426-9732
(541) 337-6165
Mailing address
4278 HYACINTH ST, EUGENE, OR 97404-4083
(541) 337-6165
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201509557LPN
OR
Other
Enumeration date
07/08/2016
Last updated
07/08/2016
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