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NPI Code Detail

MEDICARE: ELIZABETH FERNLEY

MEDICARE: ELIZABETH FERNLEY
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1730481904
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH FERNLEY
Provider Business Mailing Address
First Line : 1535 SW SHIRLEY ANN DRIVE
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1535 SW SHIRLEY ANN DR
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-7665
Country : US
Telephone Number : 503-472-9999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2010
Last Update Date : 01/24/2014

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Directions to “ ELIZABETH FERNLEY ” Practice Location

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