1689971996 NPI number — MRS. NORMA JULIANNA OLDENKAMP R.N.

Table of content: MRS. NORMA JULIANNA OLDENKAMP R.N. (NPI 1689971996)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689971996 NPI number — MRS. NORMA JULIANNA OLDENKAMP R.N.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OLDENKAMP
Provider First Name:
NORMA
Provider Middle Name:
JULIANNA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
R.N.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TORRES
Provider Other First Name:
NORMA
Provider Other Middle Name:
JULIANNA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
R.N.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1689971996
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/23/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1118 T ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97477-2474
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-977-7703
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
33142 CAMAS SWALE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CRESWELL
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97426-9732
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-510-3919
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/23/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  201043271RN , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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