Individual
TERRIE L WYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2202 E 48TH ST., DAVENPORT, IA 52807-1214
(563) 343-1810
(563) 326-1901
Mailing address
2202 E 48TH ST., DAVENPORT, IA 52807-1214
(563) 343-1810
(563) 326-1901
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
220930
NY
Other
Enumeration date
05/06/2014
Last updated
09/28/2020
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