Elizabeth Leslie Dimick, RN

Individual provider Active NPI Registered Nurse · Eagle Point, OR

NPI 1780924019 · NPPES record last updated Feb 23, 2013

Key facts

NPI
1780924019
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
201043008RN (OR)
Practice address
261 Sierra Dr
Eagle Point, OR 97524-7702
Phone
(239) 770-4960
NPI assigned
Feb 23, 2013
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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
201043008RNORMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201043008RN OR Yes

Addresses

Primary practice location

261 Sierra Dr
Eagle Point, OR 97524-7702

Mailing address

261 Sierra Dr
Eagle Point, OR 97524-7702
Phone (239) 770-4960

Other providers in Eagle Point, OR

All providers in Eagle Point, OR · Registered Nurse in Oregon

Sources for this page

Verify at the official NPI Registry.