KELLY EILEEN CHURCH


Address: 910 S Central Ave, Medford, OR 97501-7822
Phone: 5416181380

KELLY EILEEN CHURCH (NPI# 1598309387) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1598309387
Entity Type Individual
Full Name KELLY EILEEN CHURCH
Credential FNP
Practice Address 910 S Central Ave
Medford
OR 97501-7822
Mailing Address 931 Chevy Way
Medford
OR 97504-4127
Practice Telephone 5416181380
Mailing Telephone 5416903555
Enumeration Date 2019-11-05
Last Update Date 2020-07-02
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163WC0200X Registered Nurse
Specialization: Critical Care Medicine
201390291RN OR Nursing Service Providers
Y 363LF0000X Nurse Practitioner
Specialization: Family
202000541NP-PP OR Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
415 Greenbrae Dr, Medford, OR 975048140 5416597316

Other Providers KELLY CHURCH

NPI Name Taxonomy Address Enumeration
1205023389 Kelly Ann Church Internal Medicine 800 Zorn Ave, Geriatrics and Extended Care, Va Medical Center, Louisville, KY 40206-1433 2007-10-02

Office Location

Street Address 910 S CENTRAL AVE
City MEDFORD
State OR
Zip Code 97501-7822

Providers in the same location

NPI Name Taxonomy Address Enumeration
1215127519 Hillary Lynn Handelsman Nurse Practitioner 910 S Central Ave, Medford, OR 97501-7822 2007-08-01
1215568704 Erica Davoren Registered Nurse 910 S Central Ave, Medford, OR 97501-7822 2020-02-03
1245860048 La Clinica Del Valle Family Healthcare Center Inc. Internal Medicine 910 S Central Ave, Medford, OR 97501-7822 2020-01-21
1184114696 Judith Mackey Nurse Practitioner 910 S Central Ave, Medford, OR 97501-7822 2018-05-10
1366892598 Peter Michael Millard Nurse Practitioner 910 S Central Ave, Medford, OR 97501-7822 2016-06-19
1346695236 Nathaniel Fondell Family Medicine 910 S Central Ave, Medford, OR 97501-7822 2016-04-27
1821488875 Dora Hebe Best Counselor 910 S Central Ave, Medford, OR 97501-7822 2015-01-29
1417372731 La Clinica Del Valle Family Health Care Center Inc Clinic/Center 910 S Central Ave, Medford, OR 97501-7822 2014-02-24
1790108702 Julianne T Curl Nurse Practitioner 910 S Central Ave, Medford, OR 97501-7822 2014-01-27
1063737252 Laurel M Brown Physician Assistant 910 S Central Ave, Medford, OR 97501-7822 2010-03-31
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1366069494 Brian Snapp Counselor 1191 Hazel St, Medford, OR 97501 2020-07-06
1477174761 Corey Renfree Counselor 1191 Hazel Street, Medford, OR 97501 2020-04-28
1669012928 One of A Kind Therapy LLC Social Worker 916 West 10th St #205, Medford, OR 97501 2020-01-14
1265993620 Star Dialysis LLC Clinic/Center 50 Rossanley Dr, Medford, OR 97501 2019-03-28
1962972463 Karen Elise Roertgen Counselor 328 So. Central Ave., Suite 204, Medford, OR 97501 2018-11-28
1316458813 Rick's Medical Supply, Inc Durable Medical Equipment & Medical Supplies 562 Parsons Drive, Suite 114, Medford, OR 97501 2017-10-24
1750807111 La Clinica Del Valle Family Health Care Center Inc. Clinic/Center 821 N Riverside Ave, Medford, OR 97501 2017-08-17
1992229009 Cassandra Schultz Massage Therapist 824 East Jackson, Suite A, Medford, OR 97501 2017-07-31
1972962355 Robin Clevenger Peer Specialist 301 S Ivy St, Medford, OR 97501 2016-02-15
1154706984 Debbie Diane Orr Behavioral Analyst 1024 West 9th Street, Medford, OR 97501 2015-07-22
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1679113922 Elena Chapman Nurse Practitioner 293 Salem St 4, Medford, MA 02155 2020-01-14
1770005407 Suzanne Ellen Sanderson Nurse Practitioner 2620 E Barnett Rd Ste H, Medford, OR 97504-8383 2017-07-14
1194189902 Josephine Magpantay Gaviola Nurse Practitioner 101 Main St Ste 116, Medford, MA 02155-4530 2016-04-07
1033514286 Lauren E Hodgdon Nurse Practitioner 1698 E Mcandrews Rd Ste 200, Medford, OR 97504 2014-10-30
1962820209 Jessica Anne Marie Gunn Nurse Practitioner 21 Ohio Trl, Medford, NJ 08055-8931 2014-04-03
1912333451 Travis Adam Day Nurse Practitioner 70 Bower Dr Ste 110, Medford, OR 97501-3689 2013-09-16
1184058703 Ashley Riley Nurse Practitioner 101 Main St Ste 107, Medford, MA 02155-4530 2013-08-30
1578841169 Shannon Jamerson Nurse Practitioner 619 N Front St, Medford, OK 73759-2704 2011-07-29
1891081113 Debra Jeanne Zenner Nurse Practitioner 143 South Gibson St., Medford, WI 54451 2011-06-24
1366763336 Edward William Walton Nurse Practitioner 2 Pinecrest Dr, Medford, NJ 08055-8513 2010-06-14
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Competitor

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City MEDFORD
Zip Code 97501

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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