Individual
KRISTIN CORINNE GANNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
691 MURPHY RD STE 107, MEDFORD, OR 97504-4311
(541) 789-6460
Mailing address
1360 HILLCOURT ST, MEDFORD, OR 97504-6509
(541) 301-0692
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
202004201NP
OR
363LF0000X
Family Nurse Practitioner
Primary
202004201NP-PP
OR
Other
Enumeration date
06/02/2020
Last updated
06/02/2020
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