Bright Eyes Midwifery and Wild Rivers Womens Health,LLC
Organization Active NPI Nurse Practitioner · Gold Beach, OR
NPI 1386069326 · NPPES record last updated Feb 27, 2014
Key facts
- NPI
- 1386069326
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 200950160NP (OR)
- Legal business name
- BRIGHT EYES MIDWIFERY AND WILD RIVERS WOMENS HEALTH,LLC
- Practice address
- 29135 Ellensburg Ave
Gold Beach, OR 97444-8722 - Phone
- (541) 260-5762
- NPI assigned
- Feb 27, 2014
- Organization subpart
- No
Authorized official
- Name
- Kathleen Weber Dougherty
- Title
- Office Manager
- Phone
- (541) 260-5762
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner |
363L00000X | 200950160NP | OR | Yes |
| Advanced Practice Midwife |
367A00000X | 000031286N5 | OR |
Addresses
Primary practice location
29135 Ellensburg Ave
Gold Beach, OR 97444-8722
Mailing address
PO Box 1710
Gold Beach, OR 97444-1710
Phone (541) 260-5762
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 172189 | Medicaid | OR | |
| 500614877 | Medicaid | OR |
Other providers in Gold Beach, OR
- Steven Bates
- Richard Battey
- Sally Beavers
- Jeanette Black
- Alma Brannon
- Cornelius L Britt
- Brookings Counseling Center PC
- Marci Brose
- Cal-Ore Life Flight LLC
- Cal-Ore Life Flight LLC
All providers in Gold Beach, OR · Nurse Practitioner in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.