# WYNNEWOOD WELLNESS CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265149140
- **Authorized official:** MRS. KARISA JO KENNEDY APRN (APRN)
- **Authorized official phone:** (405) 473-3307

## Contact information

- **Practice address:** 1202 E KERR BLVD, WYNNEWOOD, OK 73098-2054
- **Practice address phone:** (405) 473-3307
- **Mailing address:** 1516 SW 82ND CIR, OKLAHOMA CITY, OK 73159-5943
- **Mailing address phone:** (405) 473-3307

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/01/2022
- **Last updated:** 11/01/2022