Healthcare Provider Details

I. General information

NPI: 1194713420
Provider Name (Legal Business Name): CLAUDIA L WILFERD-MORTON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17405 KILLDEER DR.
BEND OR
97707
US

IV. Provider business mailing address

17405 KILLDEER DR.
BEND OR
97707
US

V. Phone/Fax

Practice location:
  • Phone: 541-598-7129
  • Fax: 541-322-0405
Mailing address:
  • Phone: 541-598-7129
  • Fax: 541-322-0405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number200680034DP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: