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Contact Information

SANDRA M WYNN, NP
122 12TH ST
PRINCETON, WV24740
 Phone: 304-487-7000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for SANDRA M WYNN · (Female)

NPI Number 1013950823
Status Active
Credentials NP (Nurse Practitioner)
Entity Individual
Enumeration date 06/13/2006
Last updated 11/09/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • WV License # 52866
  • WV Medicaid 3810003716
  • WV Other 3810003716 BLUE CROSS
  • WV Other P00289697 MEDICARE RAILROAD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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