Healthcare Provider Details

I. General information

NPI: 1578547824
Provider Name (Legal Business Name): KATHLEEN FINLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHY S FINLEY FNP

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 11/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21990 HWY 62
SHADY COVE OR
97539-9717
US

IV. Provider business mailing address

PO BOX 550
EAGLE POINT OR
97524-0550
US

V. Phone/Fax

Practice location:
  • Phone: 541-878-2022
  • Fax: 541-878-1498
Mailing address:
  • Phone: 541-830-0333
  • Fax: 541-830-0863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number000029650NP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: