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Individual

MS. WENDY MARLENE HART

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
525 71ST ST, SPRINGFIELD, OR 97478-4203
(541) 232-9042
Mailing address
525 71ST STREET, SPRINGFIELD, OR 97478
(541) 232-9042

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201230111LPN
OR

Other

Enumeration date
04/20/2012
Last updated
04/20/2012
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