Provider Demographics
NPI:1891374252
Name:WYNN, LINDSAY MICHELE (DPM)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:MICHELE
Last Name:WYNN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:LINDSAY
Other - Middle Name:MICHELE
Other - Last Name:SHORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:655 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209-6511
Mailing Address - Country:US
Mailing Address - Phone:904-244-6810
Mailing Address - Fax:904-244-7213
Practice Address - Street 1:655 W 8TH ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-6511
Practice Address - Country:US
Practice Address - Phone:904-244-6810
Practice Address - Fax:904-244-7213
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program