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NICOLE RAE MENDOZA RN, MSN, FNP
NPI 1649638974
Nurse Practitioner - Primary Care in Medford, OR

Active since February 01, 2016
19 MYRTLE ST, MEDFORD, OR 97504(542) 773-3863 Get Directions Write a Review

NPPES record last updated: February 12, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 12, 2021, Jan 16, 2020, Jan 11, 2017 and 2 more (5 updates tracked since 2016).

About Nicole Rae Mendoza Rn, Msn, Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE RAE MENDOZA RN, MSN, FNP (NPI 1649638974) is an individual primary care provider in Medford, Oregon, licensed in Oregon (201508266NP-PP) and active in the NPI registry since February 2016. She maintains 2 additional practice locations.

NPPES Registry Identity

NPI1649638974
Entity TypeIndividualFemale
Primary Taxonomy363LP2300X
Provider Legal NameNICOLE RAE MENDOZACredential: RN, MSN, FNP
Location Address19 MYRTLE STMedford, OR 97504-7337
Mailing Address329 S Ivy StMedford, OR 97501-3174 · (541) 897-7383 · Fax (541) 320-9023
Phone(542) 773-3863
Sole ProprietorYes
Enumeration DateFebruary 1, 2016
Last NPPES UpdateFebruary 12, 20215 updates tracked since enumeration
NPPES CertifiedFebruary 12, 2021
✔ NPI 1649638974 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License✔ Licensed in OR · 201508266NP-PP
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 201508266NP-PP (OR)
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X · License 201508266NP-PP (OR)
19 MYRTLE ST, Medford, OR 97504
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11840 E Barnett Rd, Suite BMedford, OR 97504 · Phone (541) 897-7383
Location 2329 S Ivy StMedford, OR 97501-3174 · Phone (541) 897-7383 · Fax (541) 320-9023

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OLIVIA CORTEZ CPHT
Interpreter
19 MYRTLE ST
MEDFORD, OR 97504
Jackson County (541) 842-7747
PHYLLIS T. DUNCKEL MD
Family Medicine
19 MYRTLE ST
MEDFORD, OR 97504
Jackson County (541) 773-3863
TINA JENNINGS OKENFUSS LPC
Counselor (Mental Health)
19 MYRTLE ST
MEDFORD, OR 97504
Jackson County (541) 773-3863
DANA NOELLE BROOKS MA, MFT
Marriage & Family Therapist
19 MYRTLE ST
MEDFORD, OR 97504
Jackson County (541) 773-3863
DR. PAUL D. MATZ MD
Family Medicine
19 MYRTLE ST
MEDFORD, OR 97504
Jackson County (541) 773-3863
DARCIE KATHLEEN STERNENBERG MD
Internal Medicine (Nephrology)
19 MYRTLE ST
MEDFORD, OR 97504
Jackson County (541) 773-3863
DR. KRISTI NOEL HENNAN M.D.
Family Medicine
19 MYRTLE ST
MEDFORD, OR 97504
Jackson County (541) 773-3863
SUSAN KATHERINE MACKINNON M.D.
Internal Medicine
19 MYRTLE ST
MEDFORD, OR 97504
Jackson County (541) 773-3863

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Mendoza's NPI number?

The NPI number for Nicole Mendoza is 1649638974. It was assigned to this individual provider in the NPPES registry on February 1, 2016.

Where is Nicole Mendoza located?

Nicole Mendoza practices at 19 Myrtle St, Medford, OR 97504. The listed phone number is (542) 773-3863.

What is Nicole Mendoza's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

When was this NPI record last updated?

The NPPES record for Nicole Mendoza was last updated on February 12, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.