Individual
RENEE WYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
5401 OLD YORK RD, PHILADELPHIA, PA 19141-3030
(215) 456-8220
Mailing address
6912 CHESTER AVE, PHILADELPHIA, PA 19142-1209
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
SP021240
PA
Other
Enumeration date
04/10/2020
Last updated
04/10/2020
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