NPI Code Detail JSON Logo

1790540177 NPI number — MONICA ANN WYATT PMHNP

NPI Number: 1790540177
Health Care Provider/Practitioner: MONICA ANN WYATT PMHNP

Information about “1790540177” NPI (MONICA ANN WYATT PMHNP) exists in 1790540177 in HTML format HTML  |  1790540177 in plain Text format TXT  |  1790540177 in PDF (Portable Document Format) PDF  |  1790540177 in an XML format XML  formats.

NPI Number : 1790540177 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1790540177",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WYATT",
    "FirstName": "MONICA",
    "MiddleName": "ANN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PMHNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "512 ANSLEY BLVD APT E",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ALEXANDRIA",
    "MailingAddressStateName": "LA",
    "MailingAddressPostalCode": "71303-2291",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "318-321-8887",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "512 ANSLEY BLVD APT E",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ALEXANDRIA",
    "PracticeLocationAddressStateName": "LA",
    "PracticeLocationAddressPostalCode": "71303-2291",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "318-321-8887",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/15/2024",
    "LastUpdateDate": "02/15/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "163WP2201X",
          "TaxonomyName": "Ambulatory Care Registered Nurse",
          "LicenseNumber": "116043",
          "LicenseNumberStateCode": "LA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LP0808X",
          "TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
          "LicenseNumber": "00000000",
          "LicenseNumberStateCode": "LA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.