Individual
MRS. JENNIFER BROOKE COULTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2018 N ELDORADO AVE, KLAMATH FALLS, OR 97601-6414
(541) 850-1358
Mailing address
2018 N ELDORADO AVE, KLAMATH FALLS, OR 97601-6414
(541) 850-1358
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
098240
—
OR
Enumeration date
12/30/2006
Last updated
07/09/2007
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