Individual
ANITA L WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.A.
Contact information
Practice address
620 SKYLINE DRIVE, JACKSON, TN 38301
(731) 541-7070
(731) 541-7075
Mailing address
620 SKYLINE DRIVE, JACKSON, TN 38301
(731) 541-7070
(731) 541-7075
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN163107
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN15193
TN
Other
Enumeration date
09/07/2010
Last updated
07/19/2018
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