Sid Christian Keomanivong
Primary Care Nurse Practitioner · Central Point, OR
Practice location
2677 Beall LnCentral Point, OR 97502-1462
- Phone
- (702) 343-0466
NPI record
- NPI
- 1760960462
- Entity type
- Individual (Type 1)
- Enumeration date
- August 3, 2018
- Last updated
- October 8, 2019
- Sole proprietor
- No
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X |
201806379NP-PP | OR |
Mailing address
3344 Winterhaven StUnit 101
Las Vegas, NV 89108-5064
- Phone
- (702) 343-0466
About Sid Keomanivong
Sid Christian Keomanivong is a healthcare provider registered in the NPI registry with the primary taxonomy Primary Care Nurse Practitioner (code 363LP2300X). The practice location is 2677 Beall Ln, Central Point, OR 97502-1462. The NPI number 1760960462 was assigned on August 3, 2018 and the record was last updated on October 8, 2019.
Sid Keomanivong lists a license in the registry: #201806379NP-PP (OR) for Primary Care Nurse Practitioner. License numbers are self-reported to NPPES; verify them with the state licensing board.
Frequently asked questions
What is the NPI number of Sid Christian Keomanivong?
The NPI number is 1760960462.
What is the phone number of Sid Keomanivong?
The phone number listed for the practice location is (702) 343-0466.
Where is Sid Keomanivong located?
2677 Beall Ln, Central Point, OR 97502-1462.
What is the taxonomy code for Sid Keomanivong?
The primary taxonomy code is 363LP2300X – Primary Care Nurse Practitioner.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.
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