Individual
EILEEN WELDON STILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
520 MEDICAL CENTER DRIVE, SUITE 201, MEDFORD, OR 97504-4434
(541) 789-5710
(541) 789-5711
Mailing address
2620 EAST BARNETT RD SUITE H, MEDFORD, OR 97504-8383
(541) 789-4281
(541) 789-5538
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
201391437NN-PP
OR
363LA2200X
Adult Health Nurse Practitioner
26NN07370300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
191642
AMERIGROUP
NJ
01
—
2364882
UNITED HC
NJ
Enumeration date
01/23/2006
Last updated
01/30/2017
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