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General NPI Number Information
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NPI Number | 1598313876
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Entity Type | Individual
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Provider Name | LINDSEY HERNDON
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Gender | Female
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Dates
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Enumeration Date | 08/29/2019
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Last Update Date | 08/29/2019
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Provider Practice Location Address
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Address Line | 1420 JOHN ADAMS ST
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City | OREGON CITY
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State | OR
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Zip | 97045-1609
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Country | US
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Telephone | 503-656-1484
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Fax |
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Provider Business Mailing Address
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Address Line | 1345 WILDCAT DR
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City | COLUMBIA FALLS
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State | MT
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Zip | 59912-9472
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Country | US
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Telephone | 503-828-8332
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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 | 201907235NP-PP
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License Number State | OR
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