Provider Demographics
NPI:1578547824
Name:FINLEY, KATHLEEN
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:FINLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:S
Other - Last Name:FINLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:EAGLE POINT
Mailing Address - State:OR
Mailing Address - Zip Code:97524-0550
Mailing Address - Country:US
Mailing Address - Phone:541-830-0333
Mailing Address - Fax:541-830-0863
Practice Address - Street 1:21990 HWY 62
Practice Address - Street 2:
Practice Address - City:SHADY COVE
Practice Address - State:OR
Practice Address - Zip Code:97539-9717
Practice Address - Country:US
Practice Address - Phone:541-878-2022
Practice Address - Fax:541-878-1498
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR000029650NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR117353Medicaid
OR101583Medicare ID - Type Unspecified
ORS55488Medicare UPIN
OR383825Medicare Oscar/Certification