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NPI Code Detail

MEDICARE: NATALIE RAE WYNN APRN

MEDICARE: NATALIE RAE WYNN APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207LP2900XPain Medicine (Anesthesiology) Physician815950NV
2163WP0000XPain Management Registered NurseRN46729NV
3207LA0401XAddiction Medicine (Anesthesiology) Physician815950NV
4208VP0000XPain Medicine Physician815950NV
5207L00000XAnesthesiology Physician815950NV
6208VP0014XInterventional Pain Medicine Physician815950NV
72081P2900XPain Medicine (Physical Medicine & Rehabilitation) Physician815950NV
8363L00000XNurse Practitioner815950NV
92083A0300XAddiction Medicine (Preventive Medicine) Physician815950NV
10208100000XPhysical Medicine & Rehabilitation Physician815950NV

General Provider Information

NPI Number : 1407487077
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATALIE RAE WYNN APRN
Provider Business Mailing Address
First Line : 6120 S FORT APACHE RD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-6760
Country : US
Telephone Number : 702-948-8660
Fax Number :
Provider Business Practice Location Address
First Line : 6120 S FORT APACHE RD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-6760
Country : US
Telephone Number : 702-848-4443
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2020
Last Update Date : 01/13/2026

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