Provider Demographics
NPI:1962478867
Name:O'REILLY, REDEEM FALLER (NURSE PRACTITONER)
Entity Type:Individual
Prefix:MRS
First Name:REDEEM
Middle Name:FALLER
Last Name:O'REILLY
Suffix:
Gender:F
Credentials:NURSE PRACTITONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 404
Mailing Address - Street 2:
Mailing Address - City:AUMSVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97325-0404
Mailing Address - Country:US
Mailing Address - Phone:503-749-1462
Mailing Address - Fax:
Practice Address - Street 1:530 NW 27TH ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-5223
Practice Address - Country:US
Practice Address - Phone:541-766-6138
Practice Address - Fax:541-766-6186
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR000026912N7 WHCNP363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health