| Doctor Name: | MRS. LAUREN TODT WYATT |
| NPI Number: | 1194167882 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | 1-113979 |
| Business Practice Address: | 4260 Cahaba Bnd Trussville, AL - 351732432 |
| Business Phone Number: | 2059196729 |
| Business Fax Number: | |
| Mailing Address: | 4260 Cahaba Bnd, TRUSSVILLE |
| State: | AL |
| Postal Code: | 351732432 |
| Phone Number: | 2059196729 |
| Fax Number: | |
| NPI Enumeration Date: | 07/23/2013 |
| NPI Last Update Date: | 07/23/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 1-113979 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |