Provider Demographics
NPI:1528399862
Name:WYNN, FELECIA MCDONALD (RN, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:FELECIA
Middle Name:MCDONALD
Last Name:WYNN
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 N BONNIE BRAE ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-2499
Mailing Address - Country:US
Mailing Address - Phone:214-709-6425
Mailing Address - Fax:940-387-8339
Practice Address - Street 1:818 N BONNIE BRAE ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2499
Practice Address - Country:US
Practice Address - Phone:214-709-6425
Practice Address - Fax:940-387-8339
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2014-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX555096363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily