Homolka, Susan

Homolka, Susan is an individual health care provider with primary practice located at 1670 High St , Eugene OR 97401-4151. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Homolka, Susan can be contacted via phone (541) 344-9411.

Contact Information

Primary practice address
1670 High St Eugene OR 97401-4151
Phone: (541) 344-9411
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 200350028NP Oregon

Profile Details

NPI number 1174660179
LBN Legal business name Homolka, Susan
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2007
Last updated Jul 20th, 2009 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174660179 NPPES
Oregon MEDICAID 292793

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