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Individual

NANCY WYATT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
4024 CENTRAL AVE, ST PETERSBURG, FL 33711-1239
(727) 327-7656
Mailing address
4024 CENTRAL AVE, ST PETERSBURG, FL 33711-1239
(727) 327-7656

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
1263552
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
762423900
FL
Enumeration date
01/19/2007
Last updated
09/22/2011
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