Lara, Angelina

Lara, Angelina is an individual health care provider with primary practice located at 495 Sw Ramsey Ave , Grants Pass OR 97527. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Lara, Angelina can be contacted via phone (541) 476-6644.

Contact Information

Primary practice address
495 Sw Ramsey Ave Grants Pass OR 97527
Phone: (541) 476-6644
Fax: (541) 472-5673
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 091007741N1 Oregon

Profile Details

NPI number 1437155504
LBN Legal business name Lara, Angelina
Credentials RN, FNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2005
Last updated Jul 8th, 2007 - about 17 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 1437155504 NPPES
Oregon MEDICAID 039052

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