Individual
JENNIFER LAURA WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1010 PRINCE AVE STE 300, ATHENS, GA 30606-5805
(706) 425-1470
Mailing address
1010 PRINCE AVE STE 300, ATHENS, GA 30606-5805
(706) 425-1470
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN198700
GA
Other
Enumeration date
02/15/2023
Last updated
10/30/2023
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