Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 00032760 | OR |
NPI | 1033110887 |
---|---|
Provider Name | Ms. Sharon L Espersen |
First Address | Salem, OR 97302-6222 |
Second Address | Salem, OR 97302-6222 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2005 |
Last Update Date | 10/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000803 | (05) | OR |
500003014 | RAILROAD MEDICARE (01) | OR |
S45237 | (02) | OR |