Individual
KELLEY D WYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2525 COURT DR, GASTONIA, NC 28054-2140
(704) 834-3471
(704) 834-2686
Mailing address
2525 COURT DR, GASTONIA, NC 28054-2140
(704) 834-3471
(704) 834-2686
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
220138
NC
Other
Enumeration date
05/23/2016
Last updated
06/23/2016
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