Provider Demographics
NPI:1700460177
Name:FRANDSEN, CRETA ANNE (RN)
Entity Type:Individual
Prefix:
First Name:CRETA
Middle Name:ANNE
Last Name:FRANDSEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CANDI
Other - Middle Name:
Other - Last Name:DUDLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1701 NW PARKER AVE
Mailing Address - Street 2:
Mailing Address - City:WALDPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97394-9339
Mailing Address - Country:US
Mailing Address - Phone:208-914-8266
Mailing Address - Fax:
Practice Address - Street 1:1010 SW COAST HWY
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-5288
Practice Address - Country:US
Practice Address - Phone:541-265-0445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202000142RN163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health