Provider Demographics
NPI:1376904011
Name:WYATT, TONNA KARENLYN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:TONNA
Middle Name:KARENLYN
Last Name:WYATT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5221 PARAMOUNT PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5490
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5070 FAYETTEVILLE RD
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-2108
Practice Address - Country:US
Practice Address - Phone:910-739-0133
Practice Address - Fax:910-739-8915
Is Sole Proprietor?:No
Enumeration Date:2016-03-08
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5008461363LF0000X, 363LP2300X
NC163204163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care