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1083012561
BEVERLY WYNNE
MARIETTA, GA
NPI
1083012561
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LN0005X Nurse Practitioner, Neonatal, Critical Care
(Licence: GA RN079004)
Enumeration Date
2014-12-15
Last Update Date
2014-12-15
Business Address
-- BEVERLY WYNNE APRN
677 CHURCH ST NE
MARIETTA, GA 30060-1101
Phone number: 770-792-9808
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Mailing Address
-- BEVERLY WYNNE APRN
4120 BRIGADE TRL NW
KENNESAW, GA 30152-7722
Phone number: 770-424-6172
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