Provider Demographics
NPI:1669286464
Name:WYNN, DUANNA
Entity type:Individual
Prefix:
First Name:DUANNA
Middle Name:
Last Name:WYNN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8611 N 9TH ST APT B
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-1786
Mailing Address - Country:US
Mailing Address - Phone:813-516-5138
Mailing Address - Fax:
Practice Address - Street 1:8611 N 9TH ST APT B
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-1786
Practice Address - Country:US
Practice Address - Phone:813-516-5138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health