Healthcare Provider Details

I. General information

NPI: 1780174896
Provider Name (Legal Business Name): MAUREEN BARTELS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MAUREEN VOOGD

II. Dates (important events)

Enumeration Date: 05/14/2018
Last Update Date: 05/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2073 OLYMPIC ST
SPRINGFIELD OR
97477-3413
US

IV. Provider business mailing address

1863 PIONEER PKWY E # 429
SPRINGFIELD OR
97477-3907
US

V. Phone/Fax

Practice location:
  • Phone: 541-682-7453
  • Fax:
Mailing address:
  • Phone: 661-965-0874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number201600176RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: