Individual
PRANEETA B AVILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3617 S PACIFIC HWY, MEDFORD, OR 97501-8957
(541) 512-3113
Mailing address
931 CHEVY WAY, MEDFORD, OR 97504-4127
(541) 535-6239
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10030765
OR
363LP2300X
Primary Care Nurse Practitioner
10030765
OR
Other
Enumeration date
08/12/2024
Last updated
03/12/2025
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