Individual
MRS. BOBBIE J SMITH-EDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
555 BLACK OAK DRIVE, MEDFORD, OR 97504-8225
(541) 789-8000
(541) 789-8225
Mailing address
2825 E BARNETT RD, MSS, MEDFORD, OR 97504-8332
(541) 789-4281
(541) 789-4806
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
200250183
OR
363L00000X
Nurse Practitioner
Primary
200250183NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100163
—
OR
Enumeration date
06/30/2005
Last updated
06/19/2023
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