Individual
WYATT JOHN ORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP, CNP
Contact information
Practice address
7350 CLEARWATER RD, BAXTER, MN 56425-8463
(218) 454-5050
(218) 454-5052
Mailing address
212 4TH AVE S, SAUK RAPIDS, MN 56379-1825
(320) 267-0523
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11917
MN
Other
Enumeration date
08/01/2024
Last updated
12/16/2024
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