Individual
MISTY ELIZABETH VICENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1333 E BARNETT RD, MEDFORD, OR 97504-8219
(541) 779-4711
Mailing address
1333 E BARNETT RD, MEDFORD, OR 97504-8219
(541) 779-4711
(541) 779-0796
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10032608
OR
Other
Enumeration date
09/18/2024
Last updated
08/06/2026
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