EDEN PRACTITIONERS LLC NPI 1376219147

NPI Information

NPI: 1376219147
Provider Name: EDEN PRACTITIONERS LLC

Doing Business As: EDEN PRACTITIONERS

Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
843 E MAIN ST STE 204
MEDFORD, OR
ZIP 97504
Phone: (541) 329-0478
Get Directions

EDEN PRACTITIONERS LLC is a family nurse practitioner in Medford, OR. EDEN PRACTITIONERS LLC NPI is 1376219147. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Eden Practitioners.

The provider's business location address is:

843 E MAIN ST STE 204
MEDFORD, OR
ZIP 97504-137
Phone: (541) 329-0478
Fax: (541) 314-9556

The provider's authorized official is Dane Fickes .
The authorized official title is Owner and has the following contact phone number (541) 329-0478.

The enumeration date for this NPI number is 8/20/2021 and was last updated on 8/12/2022.

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	Primary
1	363LC1500X	Nurse Practitioner	Community Health	No
2	261QC1500X	Clinic/Center	Community Health	No
3	183500000X	Pharmacist		No
4	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	No
5	1835P0018X	Pharmacist	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	No
6	363LF0000X	Nurse Practitioner	Family	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: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »