PEDIATRIC TLC PC; NPI #1548930464

Contact Information

PEDIATRIC TLC PC

1819 NEBRASKA AVE
GRANTS PASS, OR 97527-5701

Phone: 541-479-2411
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Pediatrics	363LP0200X	50	Nurse Practitioner

Indicates primary specialty

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NPI Profile & details for PEDIATRIC TLC PC

NPI #	`1548930464`
LBN Legal business name	PEDIATRIC TLC PC
Authorized official	YVONNE MARTENIA - (OWNER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	09/14/2021
Last updated	08/25/2022 - About 4 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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PEDIATRIC TLC PC

Contact Information

Specialty

Pediatrics

NPI Profile & details for PEDIATRIC TLC PC

Reviews for PEDIATRIC TLC PC