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Individual

NANCY NIEHOFF MALONE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
500 SW RAMSEY AVE, GRANTS PASS, OR 97527-5554
(541) 472-7376
(541) 472-7377
Mailing address
500 SW RAMSEY AVE, GRANTS PASS, OR 97527-5554
(541) 472-7376
(541) 472-7377

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
079044252N1FNPPP
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
109423
MEDICARE PART B
OR
05
240361
OR
Enumeration date
11/18/2008
Last updated
11/18/2008
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