Provider Demographics
NPI:1629267414
Name:CORTELL, PAMELA REEGER (FNP-PP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:REEGER
Last Name:CORTELL
Suffix:
Gender:F
Credentials:FNP-PP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 MEDICAL CENTER DR
Mailing Address - Street 2:STE 300
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-4316
Mailing Address - Country:US
Mailing Address - Phone:541-282-6685
Mailing Address - Fax:541-282-6686
Practice Address - Street 1:520 MEDICAL CENTER DR
Practice Address - Street 2:STE 300
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-4316
Practice Address - Country:US
Practice Address - Phone:541-282-6685
Practice Address - Fax:541-282-6686
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200750132NP FNP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily