Wallace, Cynthia
Wallace, Cynthia is an individual health care provider with primary practice located at 1111 Crater Lake Ave , Medford OR 97504-6241. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Wallace, Cynthia can be contacted via phone (541) 732-5250.Contact Information
Primary practice address
1111 Crater Lake Ave
Medford OR 97504-6241
Phone: (541) 732-5250
Fax: (541) 732-5251
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | 201500016NP-PP | Oregon |
Profile Details
| NPI number | 1811393648 |
|---|---|
| LBN Legal business name | Wallace, Cynthia |
| Credentials | AGPCNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 5th, 2014 |
| Last updated | Sep 30th, 2020 - about 4 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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