Provider Demographics
NPI:1720070048
Name:FLETCHER, WYNETTA J (APRN)
Entity type:Individual
Prefix:
First Name:WYNETTA
Middle Name:J
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:FLETCHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DNP, APRN
Mailing Address - Street 1:214 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351-1620
Mailing Address - Country:US
Mailing Address - Phone:606-784-8682
Mailing Address - Fax:606-462-8123
Practice Address - Street 1:1733 HARRODSBURG RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3277
Practice Address - Country:US
Practice Address - Phone:859-276-5344
Practice Address - Fax:859-296-0362
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3002992363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3002992OtherKY BOARD OF NURSING
KY78003357Medicaid