Cantwell-Gab, Kim R

Cantwell-Gab, Kim R is an individual health care provider with primary practice located at 1698 E Mcandrews Rd Suite 300, Medford OR 97504-5589. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Cantwell-Gab, Kim R can be contacted via phone (541) 732-7850.

Contact Information

Primary practice address
1698 E Mcandrews Rd Suite 300 Medford OR 97504-5589
Phone: (541) 732-7850
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AP30007760 Washington
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 201503207NP-PP Oregon

Profile Details

NPI number 1962601310
LBN Legal business name Cantwell-Gab, Kim R
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2007
Last updated Sep 24th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962601310 NPPES
Washington MEDICAID 9653080

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