Church, Kelly Eileen

Church, Kelly Eileen is an individual health care provider with primary practice located at 910 S Central Ave , Medford OR 97501-7822. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Critical Care Medicine, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Church, Kelly Eileen can be contacted via phone (541) 618-1380.

Contact Information

Primary practice address
910 S Central Ave Medford OR 97501-7822
Phone: (541) 618-1380
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Critical Care Medicine 163WC0200X 201390291RN Oregon
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 202000541NP-PP Oregon

Profile Details

NPI number 1598309387
LBN Legal business name Church, Kelly Eileen
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 5th, 2019
Last updated Jul 2nd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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