Healthcare Provider Details

I. General information

NPI: 1548558745
Provider Name (Legal Business Name): DARIA YOLANDA FERRARA R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2011
Last Update Date: 07/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65877 CORI WAY
BEND OR
97701-9074
US

IV. Provider business mailing address

65877 CORI WAY
BEND OR
97701-9074
US

V. Phone/Fax

Practice location:
  • Phone: 541-318-7016
  • Fax:
Mailing address:
  • Phone: 541-318-7016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number098006356RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: