Individual provider · Type 1 NPI

Sophia Kennen Giacomelli

Nurse Practitioner · Medford, OR

NPI number 1124736764 Active

Practice location

3617 S Pacific Hwy
Medford, OR 97501-8957

Call (541) 535-6239 Map

Mailing address

931 Chevy Way
Medford, OR 97504-4127

Other practice locations

  • 638 Market St, Medford, OR 97504-6126 · (541) 535-6239

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X10048417 (OR)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1124736764

Sophia Kennen Giacomelli's National Provider Identifier is 1124736764, issued on Nov 14, 2022. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Medford, OR. The record was last updated on Oct 7, 2025.