Fuqua, Krista
Fuqua, Krista is an sole proprietor health care provider with primary practice located at 1585 Nw Washington Blvd , Grants Pass OR 97526-1049. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Fuqua, Krista can be contacted via phone (541) 474-5511.Contact Information
Primary practice address
1585 Nw Washington Blvd
Grants Pass OR 97526-1049
Phone: (541) 474-5511
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 201606762NP-PP | Oregon |
Profile Details
| NPI number | 1013347582 |
|---|---|
| LBN Legal business name | Fuqua, Krista |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 20th, 2013 |
| Last updated | Aug 12th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013347582 | NPPES |
| Texas | Other | 718569 | LICENSE |
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