| Kathryn Kolb Moon, MSN, FNP-BC | |
|
1900 Woodland Dr, Urology, Coos Bay, OR 97420-2045 | |
| (541) 267-5151 | |
| (541) 266-4574 |
| Full Name | Kathryn Kolb Moon |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 1900 Woodland Dr, Coos Bay, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508897778 | NPI | - | NPPES |
| 292415 | Medicaid | OR | |
| R0000WFBTV | Other | OR | NORTH BEND MEDICAL CENTER GROUP MEDICARE |
| 161133 | Other | OR | NORTH BEND MEDICAL CENTER GROUP MEDICAID |
| 93-0635514 | Other | OR | NORTH BEND MEDICAL CENTER GROUP TAX ID |
| 1407812365 | Other | OR | NORTH BEND MEDICAL CENTER GROUP NPI |
| P01673840 | Other | OR | PALMETTO GBA - RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 200442251RN (Oregon) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 200450152NP (Oregon) | Primary |
| Entity Name | North Bend Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407812365 PECOS PAC ID: 5597677716 Enrollment ID: O20031105000138 |
| Mailing Address | Practice Location Address |
|---|---|
| Kathryn Kolb Moon, MSN, FNP-BC 1900 Woodland Dr, Family Medicine, Coos Bay, OR 97420-2045 Ph: (541) 267-5151 | Kathryn Kolb Moon, MSN, FNP-BC 1900 Woodland Dr, Urology, Coos Bay, OR 97420-2045 Ph: (541) 267-5151 |
Jenny V Tausch, APRN PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 320 Central Ave Ste 212, Coos Bay, OR 97420 Phone: 401-217-9333 Fax: 541-543-2470 | |
Mrs. Regina M Ardiana, FNPC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1775 Thompson Rd, Coos Bay, OR 97420 Phone: 541-269-8111 Fax: 541-269-8469 | |
Angela Renee York, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1900 Woodland Dr, Coos Bay, OR 97420 Phone: 541-267-5151 | |
Mrs. Shirley Deveere Reynolds, Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 998 Inlet Loop, Coos Bay, OR 97420 Phone: 773-996-0242 | |
Mitaliben Rajendrakumar Gor, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1900 Woodland Dr, Coos Bay, OR 97420 Phone: 541-267-5151 | |
Diane H Todd, ACNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1900 Woodland Dr, Coos Bay, OR 97420 Phone: 541-267-5151 Fax: 541-266-4578 | |
Ms. Denise J Gontiz, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1900 Woodland Dr, Coos Bay, OR 97420 Phone: 541-267-5151 |