Healthcare Provider Details

I. General information

NPI: 1306751425
Provider Name (Legal Business Name): HEIDI MICHELLE BRANCATO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 COBURG RD STE A
EUGENE OR
97401-6100
US

IV. Provider business mailing address

390 COBURG RD STE A
EUGENE OR
97401-6100
US

V. Phone/Fax

Practice location:
  • Phone: 541-342-7483
  • Fax: 541-343-0193
Mailing address:
  • Phone: 541-342-7483
  • Fax: 541-343-0193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number201802347LPN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: