Organization
ACESO MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIRLEY REYNOLDS FNP (FAMILY NURSE PRACTITIONER)
(773) 996-0242
Entity
Organization
Contact information
Practice address
375 PARK AVE, COOS BAY, OR 97420-2244
(773) 996-0242
Mailing address
998 INLET LOOP, COOS BAY, OR 97420-4446
(773) 996-0242
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/05/2023
Last updated
01/05/2023
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