person
Mrs. Cynthia Wallace, AGPCNP
Gerontology Nurse Practitioner in Medford, Oregon
NPI 1811393648

Cynthia Wallace is a Gerontology Nurse Practitioner based in Portland, OR and is specialized in Gerontology. Cynthia Wallace practices in Medford, OR and has the professional credentials of AGPCNP. The NPI Number for Cynthia Wallace is 1811393648 and holds a License No. 201500016NP-PP (Oregon).

The current practice location address for Cynthia Wallace is 1111 Crater Lake Ave, Medford, OR and can be reached out via phone at 541-732-5250 and via fax at 541-732-5251.

Location: 1111 Crater Lake Ave, Medford, OR, 97208-3308
person
Provider Profile Details
NPI Number
1811393648
Provider Name
Cynthia Wallace
Credential
AGPCNP
Provider Entity Type
Individual
Gender
Female
Address
1111 Crater Lake Ave, Medford, OR, 97208-3308
Phone Number
541-732-5250
Fax Number
541-732-5251
Provider Enumeration Date
11/05/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1111 Crater Lake Ave
City
State
Zip
97504-6241
Phone Number
541-732-5250
Fax Number
541-732-5251
person
Provider Business Mailing Address Details
Address
1111 Crater Lake Ave
City
State
Zip
97504-6241
Phone Number
541-732-5250
Fax Number
541-732-5251
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Gerontology
Taxonomy
License No.
201500016NP-PP (Oregon)
Definition
Definition to come...
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