Pethtel, Elizabeth L

Pethtel, Elizabeth L is an individual health care provider with primary practice located at 3170 State St , Medford OR 97504-8450. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Community Health. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Pethtel, Elizabeth L can be contacted via phone (541) 864-8900.

Contact Information

Primary practice address
3170 State St Medford OR 97504-8450
Phone: (541) 864-8900
Fax: (541) 245-3315
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X O85072196 Oregon
Physician Assistants & Advanced Practice Nursing Providers / Community Health 363LC1500X 085072196N1 Oregon

Profile Details

NPI number 1043386717
LBN Legal business name Pethtel, Elizabeth L
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 27th, 2006
Last updated Dec 28th, 2011 - about 14 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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Identifiers

StateTypeNumberIssuer
All States NPI 1043386717 NPPES
Oregon MEDICAID 112651
Oregon Other NP (36)

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