Rose A Noah, LPN

Individual provider Active NPI Licensed Practical Nurse · Gaston, OR

NPI 1437460755 · NPPES record last updated Jul 1, 2010

Key facts

NPI
1437460755
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
000005773LPN (OR)
Practice address
320 Park St
Gaston, OR 97119-7885
Phone
(503) 985-7846
NPI assigned
Jul 1, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
000005773LPNORMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 000005773LPN OR Yes

Addresses

Primary practice location

320 Park St
Gaston, OR 97119-7885

Mailing address

320 Park St
Gaston, OR 97119-7885
Phone (503) 985-7846

Other providers in Gaston, OR

All providers in Gaston, OR · Licensed Practical Nurse in Oregon

Sources for this page

Verify at the official NPI Registry.