Mrs Jacqueline Marie Pendergrass, LPN in Florence, OR - Licensed Practical Nurse

Mrs Jacqueline Marie Pendergrass, LPN is a Licensed Practical Nurse based in Florence, Oregon. Mrs Jacqueline Marie Pendergrass is licensed to practice in Oregon (license number 200630279LPN) and her current practice location is 1255 Laurel Street, Florence, Oregon. She can be reached at her office (for appointments etc.) via phone at (541) 997-4015.

NPI number for Mrs Jacqueline Marie Pendergrass is 1447570437 and her current mailing address is Po Box 1839, Florence, Oregon. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1447570437.

Contact Information

	Mrs Jacqueline Marie Pendergrass, LPN
	1255 Laurel Street, Florence, OR 97439-0119
	(541) 997-4015
	Not Available

Provider's Profile

Full Name	Mrs Jacqueline Marie Pendergrass
Gender	Female
Speciality	Licensed Practical Nurse
Location	1255 Laurel Street, Florence, Oregon
Accepts Medicare Assignments	Does not participate in Medicare Program. She may not accept medicare assignment.

NPI Data:

NPI Number: 1447570437
Provider Enumeration Date: 06/02/2010
Last Update Date: 12/27/2010

Medical Identifiers

Medical identifiers for Mrs Jacqueline Marie Pendergrass such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1447570437	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
164W00000X	Licensed Practical Nurse	200630279LPN (Oregon)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Jacqueline Marie Pendergrass is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Jacqueline Marie Pendergrass, LPN Po Box 1839, Florence, OR 97439-0119 Ph: (541) 997-4015	Mrs Jacqueline Marie Pendergrass, LPN 1255 Laurel Street, Florence, OR 97439-0119 Ph: (541) 997-4015

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Mrs Jacqueline Marie Pendergrass, LPN - Licensed Practical Nurse in Florence, OR