Wiley, Stephanie Kendall

Wiley, Stephanie Kendall is an individual health care provider with primary practice located at 621 W Madrone St , Roseburg OR 97470-3090. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, Other Service Providers / Acupuncturist. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Wiley, Stephanie Kendall can be contacted via phone (541) 957-3700.

Contact Information

Primary practice address
621 W Madrone St Roseburg OR 97470-3090
Phone: (541) 957-3700
Fax: (541) 440-3589
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 092006677N5-NMPP-PP Oregon
Other Service Providers / Acupuncturist 171100000X AS152549 Oregon
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 092006677N5 Oregon

Profile Details

NPI number 1902076797
LBN Legal business name Wiley, Stephanie Kendall
Credentials NMNP LAC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 7th, 2008
Last updated Nov 28th, 2012 - about 14 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 1902076797 NPPES
Oregon MEDICAID 05066

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