Basic Information
| Provider Information | |||||||||
| NPI: | 1578547824 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FINLEY | ||||||||
| FirstName: | KATHLEEN | ||||||||
| MiddleName: | |||||||||
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| OtherLastName: | FINLEY | ||||||||
| OtherFirstName: | KATHY | ||||||||
| OtherMiddleName: | S | ||||||||
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| OtherCredential: | FNP | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 550 | ||||||||
| Address2: | |||||||||
| City: | EAGLE POINT | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975240550 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5418300333 | ||||||||
| FaxNumber: | 5418300863 | ||||||||
| Practice Location | |||||||||
| Address1: | 21990 HWY 62 | ||||||||
| Address2: | |||||||||
| City: | SHADY COVE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975399717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5418782022 | ||||||||
| FaxNumber: | 5418781498 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2005 | ||||||||
| LastUpdateDate: | 11/09/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 000029650NP | OR | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 117353 | 05 | OR | MEDICAID |