Individual
KAYLA WYNSMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
300 N MAIN ST STE D, CROWN POINT, IN 46307-3281
(219) 663-4888
(219) 663-4877
Mailing address
300 N MAIN ST STE D, CROWN POINT, IN 46307-3281
(219) 663-4888
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28216356A
IN
363LG0600X
Gerontology Nurse Practitioner
Primary
71006398A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201377950
—
IN
Enumeration date
02/08/2016
Last updated
07/28/2022
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