| Doctor Name: | MS. SHERRY MARIE WYNN |
| NPI Number: | 1730312265 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN |
| License Number: | A03286 |
| Business Practice Address: | 1309 W Main St Walnut Ridge, AR - 724761430 |
| Business Phone Number: | 8708863211 |
| Business Fax Number: | 8708869027 |
| Mailing Address: | 1309 W Main St, P.o. Box 839 WALNUT RIDGE |
| State: | AR |
| Postal Code: | 724761430 |
| Phone Number: | 8708863211 |
| Fax Number: | 8708869027 |
| NPI Enumeration Date: | 09/01/2009 |
| NPI Last Update Date: | 09/01/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | A03286 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |