Provider Demographics
NPI:1700672052
Name:WYATT, ALYSON K (CLD,CPD,CLSE)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:K
Last Name:WYATT
Suffix:
Gender:F
Credentials:CLD,CPD,CLSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 SW 16TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:OK
Mailing Address - Zip Code:73065-5516
Mailing Address - Country:US
Mailing Address - Phone:405-590-2041
Mailing Address - Fax:
Practice Address - Street 1:817 SW 16TH ST
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:OK
Practice Address - Zip Code:73065-5516
Practice Address - Country:US
Practice Address - Phone:405-590-2041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula