Provider Demographics
NPI:1184431918
Name:WYATT, JESSI (APRN)
Entity type:Individual
Prefix:
First Name:JESSI
Middle Name:
Last Name:WYATT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JESSI
Other - Middle Name:
Other - Last Name:MESSICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1266 HIGH STUMP RD
Mailing Address - Street 2:
Mailing Address - City:HARRINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19952-4504
Mailing Address - Country:US
Mailing Address - Phone:302-270-3287
Mailing Address - Fax:
Practice Address - Street 1:546 S BEDFORD ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-1852
Practice Address - Country:US
Practice Address - Phone:302-515-3256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELV-0000133364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist