SID KEOMANIVONG

Nurse Practitioner - Primary Care

Active Individual
NPI: 1760960462

Practice Address

2677 BEALL LN
Central Point, OR 97502

Phone: (702) 343-0466

Specialties

Specialty Code Primary License
Nurse Practitioner - Primary Care 363LP2300X Yes 201806379NP-PP (OR)

Frequently Asked Questions

NPI 1760960462 is the National Provider Identifier for SID KEOMANIVONG, a Nurse Practitioner - Primary Care provider located in Central Point, OR. This NPI was enumerated on August 3, 2018.
SID KEOMANIVONG practices at 2677 BEALL LN, Central Point, OR 97502.

Quick Facts

NPI
1760960462
Type
Individual
Enumerated
Aug 3, 2018
Last Updated
Oct 8, 2019

Nearby Providers