Wyatt Woodard MSN FNP PC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

AP1235 Issued in AZ

Legal business name

WYATT WOODARD MSN FNP PC

Practice address

320 N Leroux St
Ste B
Flagstaff, AZ 86001-4535

Phone

(928) 779-0361

Fax

(928) 779-7143

NPI assigned

Jun 8, 2005

Last updated

Jun 8, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Wyatt D Woodard, MSN, FNPNPI 1013911916

Title

Owner

Phone

(928) 779-0361

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Wyatt D Woodard, MSN, FNP

  • Family Nurse Practitioner
  • Flagstaff, AZ
  • NPI 1013911916

  Primary Care

  Medicare reassignment NPD Authorized official
• Walter Morley Taylor, MD

  • Family Medicine Physician
  • Flagstaff, AZ
  • NPI 1659380442
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307491200000",
    "number": "1720082621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 N LEROUX ST",
            "address_2": "STE B",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014535",
            "telephone_number": "928-779-0361",
            "fax_number": "928-779-7143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 N LEROUX ST",
            "address_2": "STE B",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014535",
            "telephone_number": "928-779-0361",
            "fax_number": "928-779-7143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYATT WOODARD MSN FNP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-08",
        "last_updated": "2011-06-08",
        "status": "A",
        "authorized_official_last_name": "WOODARD",
        "authorized_official_first_name": "WYATT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-779-0361",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSN, FNP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "AP1235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Wotasik
• Gerard Michael Beccia Wrenn, MS, BCBA
• Sarah E. Wright, AU.D.
• Kristine Wullenweber
• Ryan Wurzell, MS, CCC-SLP
• Wyatt Woodard MSN FNP PLLC
• Angela J Wyatt, M.D.
• Alex Wyble, DC
• David Michael Yamanaka
• David Kiwan Yang, DMD

• Primary Care Nurse Practitioner in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Primary Care Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.