Herzog, Nicole Lynn

Herzog, Nicole Lynn is an individual health care provider with primary practice located at 2145 Centennial Plz , Eugene OR 97401-2474. She recently has only one registered license in Nursing Service Related Providers / Day Training/Habilitation Specialist, which is considered as her primary health care specialty. Herzog, Nicole Lynn can be contacted via phone (541) 485-6340.

Contact Information

Primary practice address
2145 Centennial Plz Eugene OR 97401-2474
Phone: (541) 485-6340
Fax: (541) 984-3124
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Day Training/Habilitation Specialist 373H00000X

Profile Details

NPI number 1962967042
LBN Legal business name Herzog, Nicole Lynn
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 4th, 2019
Last updated Feb 4th, 2019 - about 7 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 1962967042 NPPES
Oregon MEDICAID 101YM0800X

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