Individual
DEBORAH MAUREEN WYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
815 S PINE ST, VIVIAN, LA 71082-3353
(318) 375-3239
Mailing address
815 S PINE ST, VIVIAN, LA 71082-3353
(318) 375-3239
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
339845
LA
207Q00000X
Family Medicine Physician
Primary
339845
LA
Other
Enumeration date
04/19/2020
Last updated
02/01/2024
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