Individual
STACEY L WYNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
428 COLUMBUS AVE, NEW HAVEN, CT 06519
(203) 503-3000
(203) 503-3224
Mailing address
PO BOX 7720, CREDENTIALING SPECIALIST, NEW HAVEN, CT 06519-0720
(203) 503-3174
(203) 503-3183
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1450
CT
Other
Enumeration date
08/31/2006
Last updated
08/15/2018
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