MEDICARE: R & R PRIMARY CARE ASSOCIATES, LLC

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	201709504NP-PP	OR

General Provider Information

NPI Number	:	1861980476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R & R PRIMARY CARE ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	2459 SE TV HWY # 165
Second Line	:
City	:	HILLSBORO
State	:	OR
Zip	:	97123-7919
Country	:	US
Telephone Number	:	503-887-5520
Fax Number	:

Provider Business Practice Location Address
First Line	:	617 PALM ST
Second Line	:
City	:	MEDFORD
State	:	OR
Zip	:	97501-2536
Country	:	US
Telephone Number	:	503-887-5520
Fax Number	:

Authorized Official
Title or Position	:	CEO & FNP-C
Name	:	DR. RHONDA MCMULLIN
Credential	:	DNP, FNP-C
Telephone Number	:	503-887-5520

Provider Enumeration Date	:	04/30/2018
Last Update Date	:	04/30/2018

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