Provider Demographics
NPI:1417780479
Name:BINDER, JENNIFER RENEE
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:RENEE
Last Name:BINDER
Suffix:
Gender:F
Credentials:
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 1902
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97470-0433
Mailing Address - Country:US
Mailing Address - Phone:541-821-6258
Mailing Address - Fax:
Practice Address - Street 1:1228 E FOURTH AVE
Practice Address - Street 2:
Practice Address - City:SUTHERLIN
Practice Address - State:OR
Practice Address - Zip Code:97479-9644
Practice Address - Country:US
Practice Address - Phone:541-821-6258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider