Basic Information
| Provider Information | |||||||||
| NPI: | 1982942769 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PFEIL | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | |||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 216 CHERYL LN APT 28 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975359794 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5413017172 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3617 S PACIFIC HWY | ||||||||
| Address2: | |||||||||
| City: | MEDFORD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975018957 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5415123182 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2013 | ||||||||
| LastUpdateDate: | 01/29/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 20104799RN | OR | Y | Nursing Service Providers | Registered Nurse |
No ID Information.