Individual
MRS. VASHTI A IVEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2825 E BARNETT RD, MEDFORD, OR 97504-8332
(541) 789-7000
(573) 632-5715
Mailing address
PO BOX 4749, MEDFORD, OR 97501-0227
(541) 789-4111
(541) 789-5518
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
2014032489
MO
363LF0000X
Family Nurse Practitioner
2014032489
MO
363LF0000X
Family Nurse Practitioner
Primary
201708495-NP-PP
OR
Other
Enumeration date
10/13/2014
Last updated
12/08/2017
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