Individual
LESLIE WYNVEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 662-3487
(215) 349-5534
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 662-3487
(215) 349-5534
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP028316
PA
363LA2100X
Acute Care Nurse Practitioner
Primary
AP10377
AZ
390200000X
Student in an Organized Health Care Education/Training Program
128513
CT
Other
Enumeration date
04/21/2017
Last updated
02/13/2026
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