Individual
MS. CARMEN MARIE WYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
213 RIVER WALK PKWY STE 101, CHESAPEAKE, VA 23320-6893
(757) 983-1777
(757) 507-9043
Mailing address
213 RIVER WALK PKWY STE 101, CHESAPEAKE, VA 23320-6893
(757) 983-1777
(252) 275-7507
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024175910
VA
363LP2300X
Primary Care Nurse Practitioner
WYNE-WLK81
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750021325
—
NC
Enumeration date
04/17/2018
Last updated
09/19/2024
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