Active NPI
Ivana Wynn
- Acute Care Nurse Practitioner
- Orange, CA
National Provider Identifier
1497275390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 95006800
- Practice address
- 385 S Manchester Ave Unit 1110
Orange, CA 92868 - Phone
- (562) 743-2451
- NPI assigned
- Jun 21, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 95006800 | CA | Primary |
Addresses
Primary practice location
385 S Manchester Ave Unit 1110
Orange, CA 92868
Mailing address
385 S Manchester Ave Unit 1110
Orange, CA 92868-3243
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95006800 | CA | MD | Acute Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498003200000",
"number": "1497275390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "385 S MANCHESTER AVE UNIT 1110",
"city": "ORANGE",
"state": "CA",
"postal_code": "928683243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "385 S MANCHESTER AVE UNIT 1110",
"city": "ORANGE",
"state": "CA",
"postal_code": "92868",
"telephone_number": "562-743-2451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYNN",
"first_name": "IVANA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-21",
"last_updated": "2017-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "CA",
"license": "95006800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.