Individual
MRS. EMILY J WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP BC
Contact information
Practice address
234 RUE BEAUREGARD, SUITE 100, LAFAYETTE, LA 70508-3285
(337) 593-0830
(337) 593-0122
Mailing address
234 RUE BEAUREGARD, SUITE 100, LAFAYETTE, LA 70508-3285
(337) 593-0830
(337) 593-0122
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APO 5212
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APO 5212
LOUISIANA STATE BOARD OF
LA
Enumeration date
07/30/2007
Last updated
07/28/2010
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