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General NPI Number Information
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NPI Number | 1114997244
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Entity Type | Individual
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Provider Name | EILEEN WELDON STILES NP
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Gender | Female
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 01/30/2017
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Provider Practice Location Address
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Address Line | 520 MEDICAL CENTER DRIVE, SUITE 201
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City | MEDFORD
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State | OR
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Zip | 97504-4434
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Country | US
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Telephone | 541-789-5710
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Fax | 541-789-5711
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Provider Business Mailing Address
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Address Line | 2620 EAST BARNETT RD SUITE H
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City | MEDFORD
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State | OR
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Zip | 97504-8383
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Country | US
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Telephone | 541-789-4281
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Fax | 541-789-5538
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 26NN07370300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 201391437NN-PP
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License Number State | OR
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