Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD154795 | OR |
N | 208D00000X | General Practice Physician | 96359 | NM |
NPI | 1003874199 |
---|---|
Provider Name | Dr. Mildred Helen Rowley |
First Address | Eugene, OR 97401-3238 |
Second Address | Florence, OR 97439-8831 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 24/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00NM009095 | BLUE CROSS BLUE SHIELD (01) | NM |
202027435 | PRESBYTERIAN (01) | NM |
44172257 | (05) | NM |
500646637 | (05) | OR |
F40669 | (02) |