Individual
ANDREA LYNNE WYDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
959 BROAD BLVD, DAYTON, OH 45419-2029
(937) 694-2931
(937) 298-6388
Mailing address
959 BROAD BLVD, DAYTON, OH 45419-2029
(937) 694-2931
(937) 298-6388
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
RN130797
OH
163WH0200X
Home Health Registered Nurse
Primary
RN130797
OH
163WW0000X
Wound Care Registered Nurse
RN 130797
OH
Other
Enumeration date
02/19/2009
Last updated
02/19/2009
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