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General NPI Number Information
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NPI Number | 1710245691
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Entity Type | Individual
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Provider Name | AMY SIMMONS WYNNE N.P.
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Gender | Female
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Dates
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Enumeration Date | 04/27/2012
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Last Update Date | 09/25/2017
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Provider Practice Location Address
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Address Line | 15790 PAUL VEGA MD DR HOSPITAL MEDICINE PROGRAM
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City | HAMMOND
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State | LA
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Zip | 70403-1434
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Country | US
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Telephone | 985-230-3066
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Fax | 985-230-2072
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Provider Business Mailing Address
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Address Line | PO BOX 2666
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City | HAMMOND
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State | LA
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Zip | 70404-2666
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Country | US
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Telephone | 985-230-3066
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Fax | 985-230-2072
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | AP06816
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP06816
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License Number State | LA
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