SUSAN HOMOLKA ANP NPI 1174660179

NPI Information

  • NPI: 1174660179
  • Provider Name: SUSAN HOMOLKA, ANP
  • Classification: Nurse Practitioner - 363LA2200X
  • Specialization: Adult Health
  • Entity Type: Individual
  • Address: 1670 HIGH ST
    EUGENE, OR
    ZIP 97401
  • Phone: (541) 344-9411

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NPI Details

Susan Homolka, ANP is an adult health nurse practitioner in Eugene, OR. Susan Homolka, ANP NPI is 1174660179. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1670 HIGH ST
EUGENE, OR
ZIP 97401-151
Phone: (541) 344-9411

The enumeration date for this NPI number is 1/31/2007 and was last updated on 7/20/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2200XNurse PractitionerAdult Health200350028NPOREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1292793MEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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