Provider Demographics
NPI:1093953556
Name:HIEBERT, LORRAINE KAY (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:LORRAINE
Middle Name:KAY
Last Name:HIEBERT
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:DR
Other - First Name:PAUL
Other - Middle Name:
Other - Last Name:BALMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:755 MEDICAL CENTER DR NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-2762
Mailing Address - Country:US
Mailing Address - Phone:503-585-6388
Mailing Address - Fax:503-485-3949
Practice Address - Street 1:755 MEDICAL CENTER DR NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-2762
Practice Address - Country:US
Practice Address - Phone:503-585-6388
Practice Address - Fax:503-485-3949
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR088006239RN163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health