Individual
AMY SIMMONS WYNNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
15790 PAUL VEGA MD DR, HOSPITAL MEDICINE PROGRAM, HAMMOND, LA 70403-1434
(985) 230-3066
(985) 230-2072
Mailing address
PO BOX 2666, HAMMOND, LA 70404-2666
(985) 230-3066
(985) 230-2072
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP06816
LA
363LA2100X
Acute Care Nurse Practitioner
AP06816
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2191462
—
LA
Enumeration date
04/27/2012
Last updated
09/25/2017
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