Individual
REBECCA ELIZABETH WAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
134 HOMER AVE, CORTLAND, NY 13045-1206
(607) 756-3500
Mailing address
730 STATE ROUTE 38, LOCKE, NY 13092-4132
(315) 440-6376
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
559339
NY
363LG0600X
Gerontology Nurse Practitioner
Primary
308976
NY
Other
Enumeration date
08/19/2018
Last updated
02/26/2020
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