Provider Demographics
NPI:1760685994
Name:WOLFE, CYNTHIA SPRUNK (FNP)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:SPRUNK
Last Name:WOLFE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15955 HIGHLAND CT
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-9738
Mailing Address - Country:US
Mailing Address - Phone:530-241-6721
Mailing Address - Fax:530-223-0235
Practice Address - Street 1:2315 BECHELLI LN
Practice Address - Street 2:SUITE C
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-0119
Practice Address - Country:US
Practice Address - Phone:530-223-0216
Practice Address - Fax:530-223-0235
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP10819363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily