Individual
SHANNON WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 COMMERCE CIR, H, YORKTOWN, VA 23693-4322
(757) 596-2484
Mailing address
400 COMMERCE CIR, H, YORKTOWN, VA 23693-4322
(757) 596-2484
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
1202213935
VA
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1202213935
DPOR
VA
Enumeration date
05/05/2016
Last updated
05/06/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us