Individual
MR. ELIHU DANIEL WYATT IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AGACNP
Contact information
Practice address
1180 N TOWN CENTER DR STE 100, LAS VEGAS, NV 89144-6308
(702) 202-2060
(866) 536-4161
Mailing address
1180 N TOWN CENTER DR STE 100, LAS VEGAS, NV 89144-6308
(702) 202-2060
(866) 536-4161
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
845332
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
845332
APRN LICENSE
NV
Enumeration date
09/15/2021
Last updated
09/15/2021
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