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General NPI Number Information
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NPI Number | 1356375364
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Entity Type | Individual
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Provider Name | BRENDA L WYRICK NURSE PRACTIONER-FAM
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Gender | Female
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 04/21/2020
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Provider Practice Location Address
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Address Line | 141 RVG PKWY STE 104
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City | WAXAHACHIE
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State | TX
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Zip | 75165-5288
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Country | US
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Telephone | 972-923-8923
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Fax | 888-339-3357
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Provider Business Mailing Address
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Address Line | 141 RVG PKWY STE 101
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City | WAXAHACHIE
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State | TX
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Zip | 75165-5289
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Country | US
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Telephone | 972-923-8923
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Fax | 888-339-3357
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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 | 565424
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License Number State | TX
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