Individual
TEIRRA WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
109 HIGHWAY 15 S, PONTOTOC, MS 38863-2628
(662) 509-9934
Mailing address
109 HIGHWAY 15 S, PONTOTOC, MS 38863-2628
(662) 509-9934
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
906967
MS
Other
Enumeration date
09/19/2024
Last updated
09/19/2024
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