Individual
ANGIE MARIE WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(770) 339-2395
(678) 990-3997
Mailing address
1014 VILLA RIDGE PKWY, LAWRENCEVILLE, GA 30044-2312
(404) 723-5359
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN217335
GA
Other
Enumeration date
10/09/2012
Last updated
10/09/2012
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