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Individual

MRS. LINDSEY GAVIOLI FOX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP-BC, AGACNP-BC

Contact information

Practice address
1111 CRATER LAKE AVE, MEDFORD, OR 97504-6241
(541) 732-5545
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(541) 732-5545
(541) 732-5548

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
61319
NM
363LF0000X
Family Nurse Practitioner
0993447
CO
363LG0600X
Gerontology Nurse Practitioner
Primary
201804532NP-PP
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500748692
OR
Enumeration date
10/05/2017
Last updated
06/07/2023
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