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Individual

KELLY A DALE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2825 E BARNETT RD, MEDFORD, OR 97504-8332
(541) 789-7000
(503) 220-3929
Mailing address
PO BOX 4749, MEDFORD, OR 97501-0227
(541) 789-5516
(541) 789-5518

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
200850060
OR
363LF0000X
Family Nurse Practitioner
Primary
RN665150
CA

Other

Enumeration date
07/27/2007
Last updated
09/09/2013
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