Lisa Quillin, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

097003215LPN Issued in OR

Practice address

913 NW Garden Valley Blvd
Roseburg, OR 97471-6523

Phone

(541) 440-1000

NPI assigned

May 20, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1653004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1972241958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 NW GARDEN VALLEY BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974716523",
            "telephone_number": "541-440-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 NW GARDEN VALLEY BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974716523",
            "telephone_number": "541-440-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUILLIN",
        "first_name": "LISA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-20",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OR",
            "license": "097003215LPN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurence Everett Putman I, D.D.S.
• Sarah Pytalski
• Robert Quamme, BS, CADC I
• Tamara Lee Quamme, CADC I
• Quest Diagnostics Clinical Laboratories Inc
• Corina Gabriela Rachita, MD
• Mircea S. Rachita, MD
• Deirdrah Renee Racine, QMHP
• Michael Racine, MD
• Alan L Rader, RPH

• Licensed Practical Nurse in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Licensed Practical Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.