Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 201905672NP | OR |
Y | 363LW0102X | Nurse Practitioner - Women's Health | 201905672NP-PP | OR |
NPI | 1073017463 |
---|---|
Provider Name | Donna Delaine Eoff |
First Address | Damascus, OR 97089-7855 |
Second Address | Springfield, OR 97477-1118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2018 |
Last Update Date | 24/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
500773485 | (05) | OR |