Provider Type Icon

JACLYN WYNN PA-C NPI 1356770887


NPI Information

NPI: 1356770887
Provider Name: JACLYN WYNN, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Organization: SHANDS-SOLANTIC JOINT VENTURE LLC

PECOS Registration: Yes

Address:
6440 W NEWBERRY RD
STE 401
GAINESVILLE, FL
ZIP 32605
Phone: (352) 332-0030
Get Directions

Jaclyn Wynn, PA-C is a surgical physician assistant in Gainesville, FL with 11 years of experience. Jaclyn Wynn, PA-C NPI is 1356770887. 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:

6440 W NEWBERRY RD
STE 401
GAINESVILLE, FL
ZIP 32605-381
Phone: (352) 332-0030

The NPI 1356770887 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 11/5/2013 and was last updated on 11/5/2013.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363A00000XPhysician AssistantPA9107604FLORIDANo
2363AS0400XPhysician AssistantSurgicalPA9107604FLORIDAYes

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.