Individual
STEVEN MICHAEL PRUDENCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
340 NW MEDICAL LOOP, ROSEBURG, OR 97471-1645
(541) 464-5907
Mailing address
PO BOX 2129, ODESSA, TX 79760-2129
(432) 640-1963
(432) 640-1875
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
201909746NP-PP
OR
Other
Enumeration date
09/23/2015
Last updated
09/04/2025
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