Individual
ELISA DENISE GARRETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
4488 NE DEVILS LAKE BLVD, LINCOLN CITY, OR 97367-5065
(541) 614-0407
(833) 973-5262
Mailing address
PO BOX 1193, CORVALLIS, OR 97339-1193
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
201903457NP-PP
OR
363LG0600X
Gerontology Nurse Practitioner
AG03190056
OR
Other
Enumeration date
04/16/2019
Last updated
11/18/2024
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