Individual
MELLISA JANE LEE FREE-STOUDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
STUDENT HEALTH CENTER, ONE UNIVERSITY BLVD., LA GRANDE, OR 97850
(541) 962-3524
(541) 962-3825
Mailing address
2104 1ST ST, LA GRANDE, OR 97850-1703
(541) 805-1020
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201907957NP-PP
OR
Other
Enumeration date
09/12/2019
Last updated
03/30/2020
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