Provider Demographics
NPI:1386197044
Name:WYNACHT, ADRIANNE ELIZABETH (RN, PHN)
Entity Type:Individual
Prefix:
First Name:ADRIANNE
Middle Name:ELIZABETH
Last Name:WYNACHT
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 W 21ST ST
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-7000
Mailing Address - Country:US
Mailing Address - Phone:530-680-7223
Mailing Address - Fax:
Practice Address - Street 1:229 W 21ST ST
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-7000
Practice Address - Country:US
Practice Address - Phone:530-680-7223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA720411163WC0400X, 163WC1500X, 163WG0600X, 163WH0200X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult