National Provider Identifier

Kimberly Lashawn Wyatt

Kimberly Lashawn Wyatt is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Rochester, NY and a listed phone number of (585) 354-1795.

NPI 1982223947Rochester, NYLicensed Practical Nurse

Profile Overview

NPI
1982223947
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
April 10, 2020
Last Updated
April 10, 2020

Practice Location

  • 180 Autumn Chapel Way
  • Rochester, NY 14624-5304

Phone: (585) 354-1795

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1982223947
Entity Type
Individual
Last Name
Wyatt
First Name
Kimberly
Middle Name
Lashawn
Mailing Street Address
180 Autumn Chapel Way
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14624-5304
Mailing Country
US
Mailing Phone
(585) 354-1795
Practice Street Address
180 Autumn Chapel Way
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14624-5304
Practice Country
US
Practice Phone
(585) 354-1795
Enumeration Date
April 10, 2020
Last Updated
April 10, 2020
Sex
Female
Sole Proprietor
Yes
Certification Date
April 10, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)