Individual
MARY E BARNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP
Contact information
Practice address
800 E MAIN ST, MEDFORD, OR 97504
(541) 608-7683
(541) 608-7689
Mailing address
800 E MAIN ST, MEDFORD, OR 97504-7134
(541) 608-7683
(541) 608-7689
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
087000076RN
OR
363LF0000X
Family Nurse Practitioner
Primary
201050019NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500635312
—
OR
Enumeration date
02/10/2010
Last updated
09/16/2013
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