Individual provider · NPI-1
Michael Wynn, MS, CCP
Spec/Tech, Cardiovascular · Louisville, KY
NPI number1346948890
StatusActive
Last updated in NPPESFeb 22, 2023
Details
- NPI
- 1346948890
- Entity type
- Individual (NPI-1)
- Name
- Michael Wynn
- Credential
- MS, CCP
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 22, 2023
- Certification date
- Feb 22, 2023
- Last updated
- Feb 22, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 246X00000X | Spec/Tech, Cardiovascular | – | – | Yes |
Practice location
2713 Windsor Lakes PkwyLouisville, KY 40214-4534
Phone 208-220-0854
Mailing address
2713 Windsor Lakes PkwyLouisville, KY 40214-4534
Phone 208-220-0854
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