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Individual

MS. KEESHA WYNN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CD

Contact information

Practice address
2795 FIRETHORN AVE FL 32073, ORANGE PARK, FL 32073-1699
(772) 713-1880
Mailing address
2795 FIRETHORN AVE, ORANGE PARK, FL 32073-1699
(772) 713-1880

Taxonomy

Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
RN9169385
FL
374J00000X
Doula
Primary
FL

Other

Enumeration date
09/18/2023
Last updated
10/16/2023
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