Provider Demographics
NPI:1619493574
Name:SINKINSON, W. GWYNN (CRNP)
Entity Type:Individual
Prefix:
First Name:W. GWYNN
Middle Name:
Last Name:SINKINSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:W
Other - Middle Name:GWYNN
Other - Last Name:SINKINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:323 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-3203
Mailing Address - Country:US
Mailing Address - Phone:484-905-2191
Mailing Address - Fax:
Practice Address - Street 1:634 SPROUL ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-4208
Practice Address - Country:US
Practice Address - Phone:610-872-6865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP006153C363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAVP006153COtherBON
PA53R63202OtherPRESCRIPTIVE AUTHORITY