Wyatt, Kimberly Anne
Wyatt, Kimberly Anne is an individual health care provider with primary practice located at 709 Hollybrook Dr Ste 4500 , Longview TX 75605-2412. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Wyatt, Kimberly Anne can be contacted via phone (903) 291-6287.Contact Information
Primary practice address
709 Hollybrook Dr Ste 4500
Longview TX 75605-2412
Phone: (903) 291-6287
Fax: (903) 291-6286
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 1091066 | Texas |
Profile Details
| NPI number | 1538490297 |
|---|---|
| LBN Legal business name | Wyatt, Kimberly Anne |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 20th, 2010 |
| Last updated | May 2nd, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538490297 | NPPES |
| Texas | Other | 1091066 | NCCPA CERTIFICATION |
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