Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 201250026NP | OR |
Y | 363LC1500X | Nurse Practitioner - Community Health | 201250026NP | OR |
NPI | 1023383759 |
---|---|
Provider Name | Eden Renee Aldrich |
First Address | Bend, OR 97703-8587 |
Second Address | Bend, OR 97703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2012 |
Last Update Date | 02/07/2019 |