Organization
WYATT WOODARD MSN FNP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WYATT D WOODARD MSN, FNP (OWNER)
(928) 779-0361
Entity
Organization
Contact information
Practice address
320 N LEROUX ST, STE B, FLAGSTAFF, AZ 86001-4535
(928) 779-0361
(928) 779-7143
Mailing address
320 N LEROUX ST, STE B, FLAGSTAFF, AZ 86001-4535
(928) 779-0361
(928) 779-7143
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
AP1235
AZ
Other
Enumeration date
06/08/2005
Last updated
06/08/2011
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