Provider Demographics
NPI:1922838887
Name:CARTWRIGHT-WYNN, YVETTE CAMILLE
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:CAMILLE
Last Name:CARTWRIGHT-WYNN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6711 SUMMIT CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-5820
Mailing Address - Country:US
Mailing Address - Phone:301-910-2382
Mailing Address - Fax:
Practice Address - Street 1:11100 BILLINGSLEY RD
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-3400
Practice Address - Country:US
Practice Address - Phone:202-849-5649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR176147163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse