Individual
KATHLEEN WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
400 APACHE DRIVE, WHITERIVER, AZ 85941
(928) 338-4911
(928) 338-3681
Mailing address
400 WEST APACHE DR, PO BOX 860, WHITERIVER, AZ 85941
(928) 338-4911
(928) 338-3681
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN151971
AZ
Other
Enumeration date
11/03/2011
Last updated
11/03/2011
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