Kayla Linville, RN, BSN

Individual provider Active NPI Family Medicine Physician · Enterprise, OR

NPI 1811488778 · NPPES record last updated May 25, 2018

Key facts

NPI
1811488778
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
261QF0400X (OR)
Practice address
603 Medical Pkwy
Enterprise, OR 97828-5124
Phone
(541) 426-4502
Fax
(541) 426-6403
NPI assigned
May 25, 2018
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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
261QF0400XORMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
207Q00000X 261QF0400X OR Yes

Addresses

Primary practice location

603 Medical Pkwy
Enterprise, OR 97828-5124

Mailing address

603 Medical Pkwy
Enterprise, OR 97828-5124

Other practice location 1

401 N Main St
Joseph, OR 97846-5001
Phone (541) 432-6555

Other providers in Enterprise, OR

All providers in Enterprise, OR · Family Medicine Physician in Oregon

Sources for this page

Verify at the official NPI Registry.