Healthcare Provider Details

I. General information

NPI: 1265230924
Provider Name (Legal Business Name): KIRA REOCH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2025
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1928 COURT AVE
BAKER CITY OR
97814-3445
US

IV. Provider business mailing address

255 HILLCREST DR
BAKER CITY OR
97814-4117
US

V. Phone/Fax

Practice location:
  • Phone: 530-721-1565
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number200941158RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: