Provider Demographics
NPI:1235212077
Name:WYZYKIEWICZ, LYNNE CAROL (NP)
Entity Type:Individual
Prefix:MRS
First Name:LYNNE
Middle Name:CAROL
Last Name:WYZYKIEWICZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7 GATSBY LN
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08009-1526
Mailing Address - Country:US
Mailing Address - Phone:856-767-5954
Mailing Address - Fax:856-767-8678
Practice Address - Street 1:1601 KIRKWOOD HWY
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-4917
Practice Address - Country:US
Practice Address - Phone:302-633-5452
Practice Address - Fax:302-633-5339
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00104300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily