Victoria Couch

Individual provider Active NPI Licensed Practical Nurse · Creswell, OR

NPI 1821487992 · NPPES record last updated Jan 13, 2015

Key facts

NPI
1821487992
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
201030045 (OR)
Practice address
82771 Bradford Rd
Creswell, OR 97426-9845
Phone
(310) 968-8042
NPI assigned
Jan 13, 2015
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

LicenseStateTypeSpecialty
201030045ORMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 201030045 OR Yes

Addresses

Primary practice location

82771 Bradford Rd
Creswell, OR 97426-9845

Mailing address

82771 Bradford Rd
Creswell, OR 97426-9845

Other providers in Creswell, OR

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

Sources for this page

Verify at the official NPI Registry.