Individual
KYZA COCARUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
320 SW RAMSEY AVE, GRANTS PASS, OR 97527-5529
(541) 476-2373
Mailing address
1215 SW G ST, GRANTS PASS, OR 97526-2544
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201607465RN
OR
Other
Enumeration date
06/15/2022
Last updated
06/15/2022
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