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Individual

MRS. CYNTHIA L. VANDEMARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, WHNP-BC

Contact information

Practice address
1250 RALSTON AVE STE 205, DEFIANCE, OH 43512-5310
(419) 782-5774
(419) 782-6103
Mailing address
1 SEAGATE STE 800, TOLEDO, OH 43604-1558
(567) 585-1992
(419) 824-7359

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
RN-284906-COA-1
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0095549
OH
Enumeration date
11/06/2013
Last updated
11/03/2023
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