Individual
MISS MARIA ANGELA, CHANDRA WYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
7950 MARTIN LOOP, FORT BENNING, GA 31905-5647
(706) 905-1127
Mailing address
5230 VILLAGE WAY, COLUMBUS, GA 31907-7492
(706) 905-1127
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN180653
GA
Other
Enumeration date
11/08/2007
Last updated
11/28/2018
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