Wycough, Katrenia J

Wycough, Katrenia J is an individual health care provider with primary practice located at 9900 Bren Road East , Minnetonka MN 55343-9664. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Wycough, Katrenia J can be contacted via phone (903) 681-8334.

Contact Information

Primary practice address
9900 Bren Road East Minnetonka MN 55343-9664
Phone: (903) 681-8334
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 251261 Texas
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 251261 Texas

Profile Details

NPI number 1023069242
LBN Legal business name Wycough, Katrenia J
Credentials RN, A/GNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Sep 17th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023069242 NPPES
Texas MEDICAID 29335903

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