Cavanaugh, Nancy Alexandria

Cavanaugh, Nancy Alexandria is an individual health care provider with primary practice located at 3617 S Pacific Hwy , Medford OR 97501-8957. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Cavanaugh, Nancy Alexandria can be contacted via phone (541) 535-6239.

Contact Information

Primary practice address
3617 S Pacific Hwy Medford OR 97501-8957
Phone: (541) 535-6239
Fax: (541) 512-1026
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Pediatrics 163WP0200X 201142758RN Oregon
Nursing Service Providers / Pediatrics 163WP0200X 201250005NP Oregon
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 220 Alaska
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 201250005NP Oregon

Profile Details

NPI number 1255531638
LBN Legal business name Cavanaugh, Nancy Alexandria
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 23rd, 2007
Last updated Mar 14th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255531638 NPPES
Oregon MEDICAID 500648116
Oregon Other R173833
Oregon MEDICAID NP13731

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