Lyda, Gaylene

Lyda, Gaylene is an individual health care provider with primary practice located at 2801 Nw Mercy Dr Suite 330, Roseburg OR 97471-2348. She recently has only one registered license in Nursing Service Providers / Medical-Surgical, which is considered as her primary health care specialty. Lyda, Gaylene can be contacted via phone (541) 677-3600.

Contact Information

Primary practice address
2801 Nw Mercy Dr Suite 330 Roseburg OR 97471-2348
Phone: (541) 677-3600
Fax: (541) 677-3601
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Medical-Surgical 163WM0705X 80012252 Oregon

Profile Details

NPI number 1366468506
LBN Legal business name Lyda, Gaylene
Credentials RNFA
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2006
Last updated Jul 3rd, 2008 - about 16 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 1366468506 NPPES
Oregon MEDICAID 090461

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