Individual
MR. CACY MCKINLEY WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
3300 NW EXPWY, OKLAHOMA CITY, OK 73112-4999
(405) 949-3011
Mailing address
1412 UMBER WAY, PIEDMONT, OK 73078
(276) 492-1473
Taxonomy
Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
209312
OK
Other
Enumeration date
07/25/2022
Last updated
07/25/2022
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