Individual
ANNE BERNADETTE PELLETIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
2821 DAGGETT AVE STE 200, KLAMATH FALLS, OR 97601-1106
(541) 274-8400
(541) 274-8405
Mailing address
2865 DAGGETT AVE, KLAMATH FALLS, OR 97601-1106
(541) 274-8400
(541) 274-8405
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
158443
MA
363LA2200X
Adult Health Nurse Practitioner
Primary
201609424NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500719864
—
OR
Enumeration date
07/24/2011
Last updated
02/11/2020
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