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General NPI Number Information
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NPI Number | 1215154398
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Entity Type | Individual
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Provider Name | SHEILA LOUISE WYMAN FNP
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 07/13/2015
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Provider Practice Location Address
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Address Line | 10726 STATE HIGHWAY 76 STE G
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City | FORSYTH
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State | MO
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Zip | 65653-5450
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Country | US
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Telephone | 417-546-2590
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Fax | 417-546-2594
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Provider Business Mailing Address
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Address Line | PO BOX 1239
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City | FORSYTH
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State | MO
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Zip | 65653-1239
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Country | US
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Telephone | 417-546-2590
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Fax | 417-546-2590
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 120158
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License Number State | MO
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