KELLY EILEEN CHURCH FNP NPI 1598309387

NPI Information

NPI: 1598309387
Provider Name: KELLY EILEEN CHURCH, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC

PECOS Registration: Yes

Address:
910 S CENTRAL AVE
MEDFORD, OR
ZIP 97501
Phone: (541) 618-1380
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Kelly Eileen Church, FNP is a family nurse practitioner in Medford, OR with 5 years of experience. Kelly Eileen Church, FNP NPI is 1598309387. 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:

910 S CENTRAL AVE
MEDFORD, OR
ZIP 97501-822
Phone: (541) 618-1380

The NPI 1598309387 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/5/2019 and was last updated on 7/2/2020.

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
1	163WC0200X	Registered Nurse	Critical Care Medicine	201390291RN	OREGON	No
2	363LF0000X	Nurse Practitioner	Family	202000541NP-PP	OREGON	Yes

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: 11/14/2023

NPI Synchronization or Removal

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