MEDICARE: WENDY LYNN RYNES NP

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
1	364SF0001X	Family Health Clinical Nurse Specialist	AP4141	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	AP4141	OTHER	AZ	LICENSE

General Provider Information

NPI Number	:	1821376526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY LYNN RYNES NP

Provider Business Mailing Address
First Line	:	4600 S MILL AVE
Second Line	:	#280
City	:	TEMPE
State	:	AZ
Zip	:	85282-6757
Country	:	US
Telephone Number	:	480-305-2888
Fax Number	:	480-305-2889

Provider Business Practice Location Address
First Line	:	2640 W BASELINE RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85041-6492
Country	:	US
Telephone Number	:	480-677-8282
Fax Number	:	480-677-8283

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2011
Last Update Date	:	06/09/2015

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