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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

NICOLE DIANNE WYDRA, PA-C

Active

NICOLE DIANNE WYDRA, PA-C is a Medical Physician Assistant healthcare provider located in CORVALLIS, Oregon. NPI 1962514836 is currently active in the NPPES registry. Verify at CMS.

Medical Physician Assistant · CORVALLIS, OR

Registration Details

NPI Number
1962514836
Provider Type
Individual
Gender
Female
NPI Issued
Aug 31, 2006 (19.910422508167 yrs)
Last Updated
Nov 3, 2015
License
PA153450 (OR)

Practice Information

Address
1740 NW 9TH ST
CORVALLIS, OR, 973302141
Browse OR providers · Browse ZIP 97330
Phone
5412301350
Fax
5412073477
Primary Specialty
Medical Physician Assistant
363AM0700X
Additional Specialty
Physician Assistant

Other Medical Physician Assistant Providers in CORVALLIS, OR

Name Credential NPI
ERIC CAMERON STROUD PA-C 1881670511
REGINA M. FIACCO PA-C 1518934751
MRS. ANGELA FAYE BEAN PA-C 1578507547
MS. LISA RENE ARANETA PA-C 1225061963
MICHAEL J MCCUSKER P. A.-C 1013096684
MS. ZORYANA N THOMPSON PA-C 1285815985
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.