Doctor Name: | NANCY CLARE HERIZA |
NPI Number: | 1487752515 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | M.D.14304 |
Business Practice Address: | 2339 Auburn Ave Baker City, OR - 978143831 |
Business Phone Number: | 5415249490 |
Business Fax Number: | 5415249491 |
Mailing Address: | 2339 Auburn Ave, BAKER CITY |
State: | OR |
Postal Code: | 978143831 |
Phone Number: | 5415249490 |
Fax Number: | 5415249491 |
NPI Enumeration Date: | 09/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | M.D.14304 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |