MEDICARE: JESSICA L GATTO NP

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	LG-0000417	DE
2	363LF0000X	Family Nurse Practitioner	26NJ00158000	NJ
3	363L00000X	Nurse Practitioner	201150181NP	OR

General Provider Information

NPI Number	:	1770650913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA L GATTO NP

Provider Business Mailing Address
First Line	:	PO BOX 670
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97709-0670
Country	:	US
Telephone Number	:	541-389-7741
Fax Number	:	541-278-8375

Provider Business Practice Location Address
First Line	:	2175 NW SHEVLIN PARK RD
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97703-7101
Country	:	US
Telephone Number	:	541-389-7741
Fax Number	:	541-278-8375

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

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	05/11/2017

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