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NPI Code Detail

MEDICARE: KATHRYN VARA RN

MEDICARE: KATHRYN VARA RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse201242544OR

General Provider Information

NPI Number : 1033462866
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN VARA RN
Provider Business Mailing Address
First Line : PO BOX 2355
Second Line :
City : WINSTON
State : OR
Zip : 97496-2355
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 77 SW BRANTLEY DR
Second Line :
City : WINSTON
State : OR
Zip : 97496-4526
Country : US
Telephone Number : 541-671-7885
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2012
Last Update Date : 10/17/2012

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