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General NPI Number Information
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NPI Number | 1619763612
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Entity Type | Individual
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Provider Name | KATIE MARIE GORMAN NRP
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Gender | Female
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Dates
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Enumeration Date | 04/16/2025
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 2801 NE 22ND ST
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City | LINCOLN CITY
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State | OR
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Zip | 97367-4221
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Country | US
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Telephone | 541-994-6690
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Fax |
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Provider Business Mailing Address
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Address Line | 146 SE 1ST ST
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City | NEWPORT
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State | OR
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Zip | 97365-4431
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Country | US
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Telephone | 406-402-4755
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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 | 146L00000X
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Taxonomy Name | Paramedic
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License Number | MED-PARA-LIC-49774
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License Number State | MT
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