Individual
KERRIE MINCE WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
23800 JOHN T REID PKWY, SCOTTSBORO, AL 35768-2841
(256) 999-0808
Mailing address
23800 JOHN T REID PARKWAY, SCOTTSBORO, AL 35768
(256) 999-0808
(844) 490-5875
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-115555
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-115555
RN LICENSE
AL
01
—
2016002419
ANCC
—
Enumeration date
10/13/2016
Last updated
03/27/2019
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