Individual
MIA WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
5185 PEACHTREE PKWY STE 300, PEACHTREE CORNERS, GA 30092-6543
(770) 766-3090
Mailing address
10257 MINION CT, ALPHARETTA, GA 30022-6320
(773) 620-6697
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
RN262082
GA
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
RN262082
GA
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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