Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 201505052NP-PP | OR |
NPI | 1003291584 |
---|---|
Provider Name | Molly K Torvik |
First Address | Bend, OR 97702-9738 |
Second Address | Bend, OR 97701-6028 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2015 |
Last Update Date | 24/07/2015 |