Individual
KARA DANIELLE WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
221 N CELIA AVE, MUNCIE, IN 47303-4609
(765) 747-3141
(765) 747-3175
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01076243A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201184970
—
IN
01
—
M122404064
MEDICARE
IN
01
—
M55843104
MEDICARE
IN
Enumeration date
05/07/2013
Last updated
03/13/2024
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