Individual
ALISON E. WYNNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
INTERMOUNTAIN HEALTHCARE, 5121 S COTTONWOOD ST, MURRAY, UT 84107
(801) 507-4000
(801) 507-4811
Mailing address
INTERMOUNTAIN HEALTHCARE, 5121 S COTTONWOOD ST, MURRAY, UT 84107
(801) 507-4000
(801) 507-4811
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00158616
WA
363LA2100X
Acute Care Nurse Practitioner
Primary
10952123-4405
UT
363LA2100X
Acute Care Nurse Practitioner
4330
SC
363LA2100X
Acute Care Nurse Practitioner
AP30006970
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0197481
LABOR & INDUSTRY
WA
01
—
20554U
REGENCE BLUESHIELD
WA
05
—
9645250
—
WA
Enumeration date
07/19/2006
Last updated
10/26/2018
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