MARY WYMAN FNP NPI 1265449797

NPI Information

  • NPI: 1265449797
  • Provider Name: MARY WYMAN, FNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 16319 THIRD STREET
    GUERNEVILLE, CA
    ZIP 95446
  • Phone: (707) 869-2849

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NPI Details

Mary Wyman, FNP is a family nurse practitioner in Guerneville, CA. Mary Wyman, FNP NPI is 1265449797. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

16319 THIRD STREET
GUERNEVILLE, CA
ZIP 95446
Phone: (707) 869-2849
Fax: (707) 869-1477

The NPI 1265449797 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/1/2006 and was last updated on 11/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyNP13614CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1NP13614OTHERCALIFORNIASTATE LICENSE NUMBER
2Q14735MEDICARE UPINCALIFORNIA
3ZZZ73222ZOTHERMEDICARE PART B
4551839MEDICARE OSCAR/CERTIFICATION

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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