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General NPI Number Information
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NPI Number | 1235510058
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Entity Type | Individual
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Provider Name | ERIC FILLMORE DNP FNP-C
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Gender | Male
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Dates
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Enumeration Date | 06/17/2015
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Last Update Date | 02/18/2026
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Provider Practice Location Address
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Address Line | 1900 HINES ST SE STE 190
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City | SALEM
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State | OR
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Zip | 97302-1356
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Country | US
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Telephone | 971-208-9249
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Fax | 971-342-3008
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Provider Business Mailing Address
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Address Line | 1900 HINES ST SE STE 190
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City | SALEM
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State | OR
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Zip | 97302-1356
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Country | US
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Telephone | 971-208-9249
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201900972NP
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP7996
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License Number State | AZ
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