Provider Demographics
NPI:1427791771
Name:WYNN, WILLIAM BRANDON (ARNP, FNP-BC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BRANDON
Last Name:WYNN
Suffix:
Gender:M
Credentials:ARNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11005 ROCKCLIFF DR NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35810-1224
Mailing Address - Country:US
Mailing Address - Phone:256-347-6907
Mailing Address - Fax:
Practice Address - Street 1:8914 US HIGHWAY 431
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-0157
Practice Address - Country:US
Practice Address - Phone:256-279-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-140874363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily