Individual provider · Type 1 NPI
Derek R. Wynn, PA
Medical Physician Assistant · Grangeville, ID
NPI number
1043689441
Active
Practice location
607 W Main Street
Grangeville, ID 83530
Fax (208) 983-4665
Mailing address
607 W Main St
Grangeville, ID 83530-1345
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | PA-1276 (ID) |
Medical Physician Assistant: Definition to come...
Other medical physician assistant providers in Grangeville
About NPI 1043689441
Derek R. Wynn, PA's National Provider Identifier is 1043689441, issued on Sep 16, 2015. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Grangeville, ID. The record was last updated on Sep 16, 2015.