Individual
PAULA BAGLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
777 MURPHY RD, MEDFORD, OR 97504-8425
(541) 772-2763
Mailing address
421 N RIVERSIDE AVE, MEDFORD, OR 97501-4602
(541) 613-7842
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201407177LPN
OR
Other
Enumeration date
11/01/2016
Last updated
11/01/2016
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