Wyatt, Lacey Shayann
Wyatt, Lacey Shayann is an individual health care provider with primary practice located at 1707 Linwood Dr Ste A , Paragould AR 72450. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Wyatt, Lacey Shayann can be contacted via phone (870) 236-2202.Contact Information
Primary practice address
1707 Linwood Dr Ste A
Paragould AR 72450
Phone: (870) 236-2202
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | APN0000014041 | Tennessee |
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | A01865 | Arkansas |
Profile Details
NPI number | 1649358847 |
---|---|
LBN Legal business name | Wyatt, Lacey Shayann |
Credentials | Advanced Practice Nurse (APN) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Nov 2nd, 2006 |
Last updated | Jun 15th, 2018 - about 6 years ago |
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 | 1649358847 | NPPES |
Tennessee | Other | 3345732 | MEDICARE-TN |
Tennessee | MEDICAID | 1514445 | MEDICARE-TN |
Tennessee | MEDICAID | 160259758 | MEDICARE-TN |
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