Individual
SHANNON WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
10700 N RODNEY PARHAM RD STE C11, LITTLE ROCK, AR 72212-4110
(501) 414-0438
Mailing address
3408 RUSHWOOD CV, BENTON, AR 72019-9373
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A005673
AR
Other
Enumeration date
08/06/2018
Last updated
08/06/2018
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