Individual
MRS. KIMBERLY ALLEY WYNNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2400 BELLEVUE RD, DUBLIN, GA 31021-2885
(478) 272-8266
Mailing address
480 WILLIS HOWELL RD, DANVILLE, GA 31017-4006
(478) 230-2561
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
RN274641
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN274641
APRN LICENSE
GA
Enumeration date
10/13/2022
Last updated
10/13/2022
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