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Individual

MS. VIRGINIA VANWART

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
3011 E BARNETT RD, MEDFORD, OR 97504
(541) 789-4673
(541) 789-2121
Mailing address
PO BOX 4749, MEDFORD, OR 97501-0227
(541) 789-4111
(541) 789-5518

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
202010481NP-PP
OR

Other

Enumeration date
11/21/2020
Last updated
01/17/2022
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