Healthcare Provider Details

I. General information

NPI: 1265353569
Provider Name (Legal Business Name): DILYNN FERNBAUGH RN, BSN, CNOR, RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59922 NAVAJO RD
BEND OR
97702-8905
US

IV. Provider business mailing address

59922 NAVAJO RD
BEND OR
97702-8905
US

V. Phone/Fax

Practice location:
  • Phone: 503-593-7535
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number201702771RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: