Individual
BEVERLY WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
500 N NAPPANEE ST, SUITE 11B, ELKHART, IN 46514-1503
(574) 522-9922
Mailing address
541 OTIS BOWEN DR, MUNSTER, IN 46321-4158
(219) 934-5300
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28033857
IN
Other
Enumeration date
08/15/2006
Last updated
07/08/2007
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