Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 20085002NP PMHNP-PP | OR |
NPI | 1003086927 |
---|---|
Provider Name | Ms. Barbara G Enos |
First Address | Klamath Falls, OR 97603-4583 |
Second Address | Klamath Falls, OR 97603-4596 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2008 |
Last Update Date | 06/03/2008 |