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NPI Code Detail

MEDICARE: SAMMI WYATT HIS

MEDICARE: SAMMI WYATT HIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1237700000XHearing Instrument Specialist674TN

General Provider Information

NPI Number : 1770717399
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMMI WYATT HIS
Provider Business Mailing Address
First Line : 40 BURTON HILLS BLVD STE 200
Second Line :
City : NASHVILLE
State : TN
Zip : 37215-5902
Country : US
Telephone Number : 615-308-3499
Fax Number :
Provider Business Practice Location Address
First Line : 40 BURTON HILLS BLVD STE 200
Second Line :
City : NASHVILLE
State : TN
Zip : 37215-5902
Country : US
Telephone Number : 615-244-1229
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2009
Last Update Date : 07/28/2022

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