Individual
MRS. HEATHER WYNNE-PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4001 E FLETCHER AVE, MDC50, TAMPA, FL 33613-4808
(813) 974-4355
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-4325
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN9327709
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018204600
—
FL
01
—
EKVNR
BLUE CROSS BLUE SHIELD
FL
Enumeration date
12/24/2015
Last updated
04/09/2025
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