Van Over, Mark L.
Van Over, Mark L. is an individual health care provider with primary practice located at 1900 Woodland Dr , Coos Bay OR 97420-2045. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Van Over, Mark L. can be contacted via phone (541) 267-5151.Contact Information
Primary practice address
1900 Woodland Dr
Coos Bay OR 97420-2045
Phone: (541) 267-5151
Fax: (541) 266-4589
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | NP 17478 | California |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 201500476NP-PP | Oregon |
Profile Details
| NPI number | 1306015417 |
|---|---|
| LBN Legal business name | Van Over, Mark L. |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 22nd, 2008 |
| Last updated | Sep 22nd, 2016 - about 10 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 | 1306015417 | NPPES |
| Oregon | Other | 1407812365 | NORTH BEND MEDICAL CENTER GROUP NPI |
| Oregon | MEDICAID | 500712548 | NORTH BEND MEDICAL CENTER GROUP NPI |
| Oregon | Other | R0000WFBTV | NORTH BEND MEDICAL CENTER GROUP NPI |
| Oregon | Other | 161133 | NORTH BEND MEDICAL CENTER GROUP NPI |
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