Individual
BRITTANY WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
412 HAWK RD, MEDFORD, OR 97501-8556
(541) 517-1111
Mailing address
412 HAWK RD, MEDFORD, OR 97501-8556
(541) 517-1111
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10055528
OR
Other
Enumeration date
01/14/2026
Last updated
01/14/2026
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