Individual
KELLY WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4 BYPASS RD STE 104, SALEM, NJ 08079-2053
(610) 619-7460
Mailing address
333 HICKORY AVE, ASTON, PA 19014-1100
(610) 306-1509
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
26NJ00996800
NJ
207RP1001X
Pulmonary Disease Physician
26NJ00996800
NJ
363LA2100X
Acute Care Nurse Practitioner
SP024697
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033756044
—
NJ
Enumeration date
12/09/2019
Last updated
07/01/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up