Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 202102539NP-PP | OR |
NPI | 1023693462 |
---|---|
Provider Name | Eva-Lynn Lund |
First Address | Klamath Falls, OR 97601-8720 |
Second Address | Klamath Falls, OR 97601-7151 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2021 |
Last Update Date | 17/03/2021 |