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:
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Health care specialties

SpecialtyCodeLicense #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 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649358847 NPPES
Tennessee Other 3345732 MEDICARE-TN
Tennessee MEDICAID 1514445 MEDICARE-TN
Tennessee MEDICAID 160259758 MEDICARE-TN

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