Provider Demographics
NPI:1477986248
Name:WYATT, APRIL (FNP-C)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:
Last Name:WYATT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3623 J DEWEY GRAY CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-6511
Mailing Address - Country:US
Mailing Address - Phone:706-854-9932
Mailing Address - Fax:
Practice Address - Street 1:3623 J DEWEY GRAY CIR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6511
Practice Address - Country:US
Practice Address - Phone:706-854-9932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-15
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95027563163W00000X
NY337831363LF0000X
CA95000510363LF0000X
GA275355363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB214311Medicare UPIN