Most Relevant Information
Provider Data
| NPI Number: | 1003651340 |
| Provider Name: | SALLY LYNNETTE HUMPHRIES LPN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | LP00055742 |
Most Important Dates
| Enumeration Date: | 06/27/2024 |
| Last Updated: | 06/27/2024 |
Provider Practice Location
1622 NE 9TH AVE
OAK HARBOR
WA
982774360
Practice Location Phone/Fax
| Phone: | 9719409499 |
| Fax: |
Provider Mailing Location
1622 NE 9TH AVE
OAK HARBOR
WA
982774360
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |