Nikki Rae Proctor, LPN
Individual provider Active NPI Licensed Practical Nurse · Creswell, OR
NPI 1740948272 · NPPES record last updated Dec 1, 2021
Key facts
- NPI
- 1740948272
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 201704153LPN (OR)
- Practice address
- 735 S 2ND St
Creswell, OR 97426-7507 - Phone
- (541) 895-3333
- Fax
- (360) 356-9020
- NPI assigned
- Dec 1, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201704153LPN | OR | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 201704153LPN | OR | Yes |
Addresses
Primary practice location
735 S 2ND St
Creswell, OR 97426-7507
Mailing address
735 S 2ND St
Creswell, OR 97426-7507
Phone (541) 895-3333
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Other | N/A |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nikki.proctor@prestigecare.com | Direct |
Other providers in Creswell, OR
- Toni Lea Patterson
- Taylor Patton
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- Brandon Michael Peterson
- Chelsea K Pisani
- Paul Ramirez
- Allison Ranieri
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- Sarah Rose
- David Sanderbrink
All providers in Creswell, OR · Licensed Practical Nurse in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2021. 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.