Provider Demographics
NPI:1073972527
Name:WYNN, KYLA JONES (NP)
Entity type:Individual
Prefix:
First Name:KYLA
Middle Name:JONES
Last Name:WYNN
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1293 ELDRIDGE PKWY # W1084
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-1670
Mailing Address - Country:US
Mailing Address - Phone:832-486-1483
Mailing Address - Fax:713-570-5816
Practice Address - Street 1:1293 ELDRIDGE PKWY # W1084
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-1670
Practice Address - Country:US
Practice Address - Phone:832-486-1483
Practice Address - Fax:713-570-5816
Is Sole Proprietor?:No
Enumeration Date:2016-02-12
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP121958363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health