Provider Demographics
NPI:1790840882
Name:TOEPKE, MARION LORRAINE (RN FNP CNM)
Entity Type:Individual
Prefix:MRS
First Name:MARION
Middle Name:LORRAINE
Last Name:TOEPKE
Suffix:
Gender:F
Credentials:RN FNP CNM
Other - Prefix:MRS
Other - First Name:MARION
Other - Middle Name:LORRAINE
Other - Last Name:TOEPKE MCLEAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:38574 DEXTER RD
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:OR
Mailing Address - Zip Code:97431
Mailing Address - Country:US
Mailing Address - Phone:541-937-3034
Mailing Address - Fax:
Practice Address - Street 1:3579 FRANKLIN BLVD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97403-2356
Practice Address - Country:US
Practice Address - Phone:541-344-9411
Practice Address - Fax:541-344-6519
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0034202RN163W00000X
OR0034202N1363LF0000X
OR0034202N5367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1LC5381CMedicaid
O49544Medicare UPIN