Individual
NIKI S LEWIS-WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
221 S GRAND AVE, CHEROKEE, OK 73728-2029
(580) 307-6263
(580) 603-8602
Mailing address
221 S GRAND AVE, CHEROKEE, OK 73728-2029
(580) 307-6263
(580) 603-8602
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
758
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100132420C
—
OK
Enumeration date
07/26/2005
Last updated
12/12/2025
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