Cinda Lou Wallace, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R0804730 Issued in MN

Practice address

1101 Moulton and Parsons Dr
Saint James, MN 56081-5550

Phone

(507) 375-3261

NPI assigned

Nov 29, 2005

Last updated

Jan 10, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mayo Clinic Health System-Southwest Minnesota Region

  dba Mayo Clinic Health System - Mankato

  • Multi-Specialty Clinic/Center
  • Mankato, MN
  • NPI 1578545422
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610236800000",
    "number": "1003899535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014752",
            "telephone_number": "507-625-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MOULTON AND PARSONS DR",
            "city": "SAINT JAMES",
            "state": "MN",
            "postal_code": "560815550",
            "telephone_number": "507-375-3261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Drew Ave SE",
            "address_purpose": "LOCATION",
            "city": "Madelia",
            "state": "MN",
            "postal_code": "560621841",
            "country_code": "US",
            "telephone_number": "507-642-3241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CINDA",
        "middle_name": "LOU",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-29",
        "last_updated": "2021-01-10",
        "certification_date": "2021-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R0804730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - Pleasant View)
• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - Brandt Ridge)
• Michael David Tonsager, MA., DPT
• Unity Transportation (Unity Transportation Corp)
• Sean Patrick Vostad, BS, DDS
• Watonwan County (TMT (Take Me There))
• Wellspring Faith in Action
• Paul R Windschill, RPH
• Dawn Witcraft
• Youngren Family Dental Care Center, Inc.

• Family Nurse Practitioner in Saint James, MN
• Providers in Saint James, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.