Individual
MRS. LISA ANN WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
41718 W MORGAN AVE STE 101, PENNINGTON GAP, VA 24277-3224
(276) 231-9228
(877) 770-7177
Mailing address
334 CORINTH CHURCH DR, JONESVILLE, VA 24263-7992
(606) 795-7533
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0024184082
VA
363L00000X
Nurse Practitioner
3010956
KY
363LF0000X
Family Nurse Practitioner
Primary
0024184082
VA
Other
Enumeration date
01/06/2010
Last updated
03/17/2025
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