Provider Demographics
NPI:1740890367
Name:WYNINGER, EMILY (FNP-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:WYNINGER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 DOCTOR MICHAEL DEBAKEY DR STE A
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-5785
Mailing Address - Country:US
Mailing Address - Phone:337-312-8960
Mailing Address - Fax:337-312-8961
Practice Address - Street 1:711 DOCTOR MICHAEL DEBAKEY DR STE A
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-5785
Practice Address - Country:US
Practice Address - Phone:337-312-8960
Practice Address - Fax:337-312-8961
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-07
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000926363LF0000X
LA215697363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily