Provider Demographics
NPI:1962001586
Name:STAFFLER, BOBIJO (FNP)
Entity Type:Individual
Prefix:
First Name:BOBIJO
Middle Name:
Last Name:STAFFLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:BOBIJO
Other - Middle Name:
Other - Last Name:WHEELOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2850 DAGGETT AVE
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-1107
Mailing Address - Country:US
Mailing Address - Phone:541-274-8610
Mailing Address - Fax:
Practice Address - Street 1:2850 DAGGETT AVE
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-1107
Practice Address - Country:US
Practice Address - Phone:541-274-8610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-23
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202008469NP-PP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner