ELIZABETH L PETHTEL FNP NPI 1043386717

NPI Information

  • NPI: 1043386717
  • Provider Name: ELIZABETH L PETHTEL, FNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • Address: 3170 STATE ST
    MEDFORD, OR
    ZIP 97504
  • Phone: (541) 864-8900

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NPI Details

Elizabeth L Pethtel, FNP is a family nurse practitioner in Medford, OR. Elizabeth L Pethtel, FNP NPI is 1043386717. 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:

3170 STATE ST
MEDFORD, OR
ZIP 97504-450
Phone: (541) 864-8900
Fax: (541) 245-3315

The enumeration date for this NPI number is 11/27/2006 and was last updated on 12/28/2011.

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
1363LC1500XNurse PractitionerCommunity Health085072196N1OREGONNo
2363LF0000XNurse PractitionerFamilyO85072196OREGONYes

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
1112651MEDICAIDOREGON
2C42479MEDICARE UPIN
3NP (36)OTHEROREGONDMAP
4112651MEDICARE ID-TYPE UNSPECIFIEDOREGON

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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