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General NPI Number Information
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NPI Number | 1144580259
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Entity Type | Organization
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Legal Business Name | RIVER ROAD FIRST ASSISTING
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Dates
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Enumeration Date | 05/22/2012
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Last Update Date | 05/22/2012
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Provider Practice Location Address
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Address Line | 5434 RIVER RD N #216
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City | KEIZER
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State | OR
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Zip | 97303-4429
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Country | US
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Telephone | 408-506-9988
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Fax |
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Provider Business Mailing Address
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Address Line | 5434 RIVER RD N #216
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City | KEIZER
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State | OR
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Zip | 97303-4429
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Country | US
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Telephone | 408-506-9988
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | MS. DEBRA ANN LOHMEYER
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Credential | RN, RNFA
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Telephone | 408-506-9988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | 200840121RN
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License Number State | OR
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