Individual
KELLI S WYNEGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
25 MONUMENT RD STE 295, YORK, PA 17403-5049
(717) 812-7676
(717) 461-7155
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 812-7676
(717) 461-7155
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP013414
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1028883820001
—
PA
Enumeration date
12/03/2013
Last updated
11/19/2021
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