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Individual

CAROL ANN WYNN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
207 CARTER ST, BERRYVILLE, AR 72616-4303
(870) 438-5216
Mailing address
207 CARTER ST, BERRYVILLE, AR 72616-4303
(870) 438-5216

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R072762
AR
363LF0000X
Family Nurse Practitioner
2021004782
MO
363LF0000X
Family Nurse Practitioner
Primary
214692
AR

Other

Enumeration date
04/13/2021
Last updated
08/05/2022
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