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Individual

SHIRLEY JEAN MIDDLESTETTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
90650 NADEAU RD, SPRINGFIELD, OR 97478-8713
(541) 914-8901
(541) 746-9363
Mailing address
90650 NADEAU RD, SPRINGFIELD, OR 97478-8713
(541) 914-8901
(541) 746-9363

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
000032064RN
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
163WC1500X
OR
Enumeration date
03/14/2016
Last updated
03/14/2016
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