Individual
AMBER NICOLE WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
644 HIGHWAY 114 S, SCOTTS HILL, TN 38374-5023
(731) 968-3646
(731) 968-1870
Mailing address
PO BOX 187, SCOTTS HILL, TN 38374-0187
(731) 614-1034
(731) 549-1011
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
APN0000008360
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3349547
—
TN
01
—
4069459
BLUE CROSS PROVIDER NUMBE
TN
01
—
4138067
BCBS
TN
Enumeration date
12/05/2005
Last updated
08/11/2022
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