Mrs Cynthia Wallace, AGPCNP | |
1111 Crater Lake Ave, Medford, OR 97504-6241 | |
(541) 732-5250 | |
(541) 732-5251 |
Full Name | Mrs Cynthia Wallace |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Experience | 10 Years |
Location | 1111 Crater Lake Ave, Medford, Oregon |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1811393648 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LG0600X | Nurse Practitioner - Gerontology | 201500016NP-PP (Oregon) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Providence Medford Medical Center | Medford, OR | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Providence Health And Services Oregon | 6305755000 | 20 |
Entity Name | Providence Health & Services Oregon |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1093976243 PECOS PAC ID: 3476450560 Enrollment ID: O20031217000186 |
Entity Name | Providence Health & Services Oregon |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1043366172 PECOS PAC ID: 6305755000 Enrollment ID: O20040126000526 |
Mailing Address | Practice Location Address |
---|---|
Mrs Cynthia Wallace, AGPCNP Po Box 3308, Portland, OR 97208-3308 Ph: (541) 732-5250 | Mrs Cynthia Wallace, AGPCNP 1111 Crater Lake Ave, Medford, OR 97504-6241 Ph: (541) 732-5250 |
Carla Ann Cochran, NP-C, FNP, AGACNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 555 Black Oak Dr., Suite 300, Medford, OR 97504 Phone: 903-463-0003 | |
Christine Ann Stanek, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2859 State Street, Suite 101, Medford, OR 97504 Phone: 541-282-6505 Fax: 541-282-6520 | |
Lena Lori Varner, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 520 Medical Center Dr Ste 300, Medford, OR 97504 Phone: 541-930-8907 Fax: 541-245-4820 | |
Mrs. Lauren E Hodgdon, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1698 E Mcandrews Rd Ste 200, Medford, OR 97504 Phone: 541-732-5537 | |
Kaitlin Eileen Stapleton, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2900 State St, Medford, OR 97504 Phone: 541-779-1672 | |
Elizabeth L Pethtel, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3170 State St, Medford, OR 97504 Phone: 541-864-8900 Fax: 541-245-3315 | |
Matthew Filoon, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3011 E Barnett Rd, Medford, OR 97504 Phone: 541-789-4673 Fax: 541-789-2121 |