Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Laneta T Wynn, NURSEPRACTITIONER

Individual provider Gerontology Nurse Practitioner · NPI 1831907765

Laneta T Wynn, NURSEPRACTITIONER is a Nurse Practitioner in Burbank, California. Qualified in 2024, 2 years ago. Practices as a sole proprietor. Licensed in California.

Years since qualifying
2
Licensed in
CA
In the registry since
2024

Practice location Address checks out

2501 W Burbank Blvd
Burbank, CA 91505-2347
Phone: (877) 929-6863
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 95030436 (CA)

Record details

NPI number1831907765
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorYes
NPI enumeratedDecember 23, 2024
Last updated in NPPESSeptember 10, 2025
Certification dateSeptember 10, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Burbank