IndividualActive
Ryan Wallace, CFA
NPI 1285070326 · Surgical Physician Assistant · Cheyenne, WY
Provider details
- NPI number
- 1285070326
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CFA
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Surgical Assistant246ZC0007X
Technologists, Technicians & Other Technical Service Providers
Practice location
101 W 1st Ave
Cheyenne, WY 82001-1330
Phone: (970) 391-1886
Approximate (ZIP-level) locationGet directions
Mailing address
101 W 1st Ave
Cheyenne, WY 82001-1330
Registry dates
- Enumerated
- 2013-05-16
- Last updated
- 2023-09-11
- Certified
- 2023-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.