MEDICARE: VILMA LORENA RANGEL APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	404190	NY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP139192	TX
3	363L00000X	Nurse Practitioner	202214129NP-PP	OR
4	363LF0000X	Family Nurse Practitioner	AP139192	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AP139192	OTHER	TX	APRN LICENSE NUMBER

General Provider Information

NPI Number	:	1033684642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VILMA LORENA RANGEL APRN

Provider Business Mailing Address
First Line	:	PO BOX 3417
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97208-3417
Country	:	US
Telephone Number	:	503-413-3900
Fax Number	:	503-413-3710

Provider Business Practice Location Address
First Line	:	1475 MOUNT HOOD AVE STE 160
Second Line	:
City	:	WOODBURN
State	:	OR
Zip	:	97071-9263
Country	:	US
Telephone Number	:	971-983-5214
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2018
Last Update Date	:	06/10/2026

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Directions to “ VILMA LORENA RANGEL APRN” Practice Location

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