Nathan Grey Lystrup, FNP is a
Nurse Practitioner - Family based in Boardman, Oregon. Nathan Grey Lystrup is licensed to practice in Oregon (license number 201605983NP-PP) and his current practice location is
450 Tatone St, Boardman, Oregon. He can be reached at his office (for appointments etc.) via phone at
(541) 481-7212.
NPI number for Nathan Grey Lystrup is 1659825651 and his current mailing address is 1967 Ne 2nd St, Hermiston, Oregon. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1659825651.
Provider's Profile
| Full Name | Nathan Grey Lystrup |
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| Gender | Male |
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| Speciality | Nurse Practitioner - Family |
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| Location | 450 Tatone St, Boardman, Oregon |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1659825651
- Provider Enumeration Date: 08/08/2016
- Last Update Date: 08/08/2016
Medical Identifiers
Medical identifiers for Nathan Grey Lystrup such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1659825651 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163W00000X | Registered Nurse | 201605982RN (Oregon) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 201605983NP-PP (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. Nathan Grey Lystrup 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 |
|---|
Nathan Grey Lystrup, FNP
1967 Ne 2nd St,
Hermiston, OR 97838-1721
Ph: (702) 596-4157 | Nathan Grey Lystrup, FNP
450 Tatone St,
Boardman, OR 97818-8076
Ph: (541) 481-7212 |
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