MEDICARE: MRS. CATHY ANN LAMB FNP

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	363LF0000X	Family Nurse Practitioner	201391715NP-PP	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346674744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CATHY ANN LAMB FNP

Provider Business Mailing Address
First Line	:	PO BOX 550
Second Line	:
City	:	EAGLE POINT
State	:	OR
Zip	:	97524-0550
Country	:	US
Telephone Number	:	541-830-3392
Fax Number	:	541-830-0863

Provider Business Practice Location Address
First Line	:	275 LOTO ST
Second Line	:
City	:	EAGLE POINT
State	:	OR
Zip	:	97524-9517
Country	:	US
Telephone Number	:	541-830-3392
Fax Number	:	541-830-0863

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

Provider Enumeration Date	:	08/21/2013
Last Update Date	:	01/08/2014

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