Individual
COURTNEY WYETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7125 JANES AVE STE 300, WOODRIDGE, IL 60517-2304
(630) 413-5800
Mailing address
1405 WILKESBORO DR, O FALLON, MO 63368-8851
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
151651
MO
Other
Enumeration date
07/21/2025
Last updated
07/21/2025
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