Healthcare Provider Details

I. General information

NPI: 1427848910
Provider Name (Legal Business Name): KRISTEN WYNNS, PH.D., PLLC DBA WYNNS FAMILY PSYCHOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2025
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 PRESTON EXECUTIVE DR
CARY NC
27513-8433
US

IV. Provider business mailing address

130 PRESTON EXECUTIVE DR
CARY NC
27513-8433
US

V. Phone/Fax

Practice location:
  • Phone: 919-467-7777
  • Fax:
Mailing address:
  • Phone: 919-467-7777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State

VIII. Authorized Official

Name: KRISTEN WYNNS
Title or Position: OWNER
Credential: PH.D.
Phone: 919-805-0182