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Organization
WYATT WOODARD MSN FNP PLLC
Active
Organization
WYATT WOODARD MSN FNP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WYATT D WOODARD MSN FNP (CEO)
(928) 779-0361
Entity
Organization
Contact information
Practice address
320 N. LEROUX, SUITE B, FLAGSTAFF, AZ 86001-4535
(928) 779-0361
(928) 779-7143
Mailing address
320 N LEROUX ST, SUITE B, FLAGSTAFF, AZ 86001-4535
(928) 779-0361
(928) 779-7143
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP1235
AZ
363LF0000X
Family Nurse Practitioner
Primary
AP1235
AZ
Other
Enumeration date
05/12/2009
Last updated
06/01/2009
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