Healthcare Provider Details

I. General information

NPI: 1982495826
Provider Name (Legal Business Name): KRISTINE HOHULIN APRN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1128 NW HARRIMAN ST
BEND OR
97703-1947
US

IV. Provider business mailing address

PO BOX 4228
PORTLAND OR
97208-4228
US

V. Phone/Fax

Practice location:
  • Phone: 541-383-3005
  • Fax: 541-383-1883
Mailing address:
  • Phone: 541-383-3005
  • Fax: 541-383-1883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10044324
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: