Doctor Name: | MRS. KAREN D WYATT |
NPI Number: | 1639428550 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 28124742A |
Business Practice Address: | 260 S Maple St Orleans, IN - 474521724 |
Business Phone Number: | 8128653350 |
Business Fax Number: | 8128653814 |
Mailing Address: | 260 S Maple St, ORLEANS |
State: | IN |
Postal Code: | 474521724 |
Phone Number: | 8128653350 |
Fax Number: | 8128653814 |
NPI Enumeration Date: | 09/06/2012 |
NPI Last Update Date: | 09/06/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 28124742A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |