Healthcare Provider Details

I. General information

NPI: 1134731193
Provider Name (Legal Business Name): CYNTHIA NACHAE WRENN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2020
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 N BECKLEY AVE
DALLAS TX
75203-1201
US

IV. Provider business mailing address

221 W COLORADO BLVD STE 525
DALLAS TX
75208-2312
US

V. Phone/Fax

Practice location:
  • Phone: 214-960-5681
  • Fax:
Mailing address:
  • Phone: 214-960-5681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number221181
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number221181
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1010454
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: