Wyatt Woodard Msn Fnp Pllc

NPI 1578797122 - Nurse Practitioner - 363L00000X

NPI Details
NPI 1578797122
Enumeration Date 05/12/2009
Last Updated 06/01/2009
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name WYATT D WYATT
Position CEO
Phone (928) 779-0361
Fax (928) 779-7143
Practice Location
320 N. LEROUX
SUITE B
FLAGSTAFF AZ, 86001-4535, US
Phone (928) 779-0361
Fax (928) 779-7143
Business Location
320 N LEROUX ST
SUITE B
FLAGSTAFF AZ, 86001-4535, US
Phone (928) 779-0361
Fax (928) 779-7143
Toxanomy
Taxonomy Code 363L00000X
License State Arizona
License Number AP1235
Remove 1578797122 NPI Number
 

According to our database, Wyatt Woodard Msn Fnp Pllc NPI is 1578797122, taxonomy code is 363L00000X and license number is AP1235, license state is located at Arizona. Wyatt Woodard Msn Fnp Pllc physically located at 320 N. Leroux, Flagstaff AZ, 86001-4535. NPI Number 1033115704 has the healthcare provider type.

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1578797122 NPI number is provided on an as is basis without warranty of any kind. 1578797122 is maintained by the National Plan & Provider Enumeration System. The contents of Wyatt Woodard Msn Fnp Pllc are for informational purposes only.