TRACI L WYATT (NPI# 1346401650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346401650 |
| Entity Type | Individual |
| Full Name | TRACI L WYATT |
| Credential | OPTICIAN |
| Practice Address |
104 W Colt Square Dr Suite 2 Fayetteville AR 72703-2834 |
| Practice Telephone | 4792519482 |
| Mailing Telephone | 4792519482 |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2008-06-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
L-920822 | AR | Eye and Vision Services Providers |
| Street Address |
104 W COLT SQUARE DR SUITE 2 |
| City | FAYETTEVILLE |
| State | AR |
| Zip Code | 72703-2834 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154391 | Margaret Sorrells | Pharmacist | 3909 N Mall Ave Attn:pharmacy, Fayetteville, AR 72703 | 2020-11-06 |
| 1497369631 | Justin A Rand | Massage Therapist | 88 W Colt Square Dr, Fayetteville, Ar 72703, Fayetteville, AR 72703 | 2020-09-04 |
| 1235777558 | Washington Regional Medical System | Specialist | 3264 N North Hills Blvd, Fayetteville, AR 72703 | 2019-12-17 |
| 1760024582 | Haley Brooke Thompson | Occupational Therapist | 2474 E Joyce Blvd Ste 2, Null, Fayetteville, AR 72703 | 2019-10-14 |
| 1306492129 | Bhg L, LLC | Clinic/Center | 8 Colt Square Drive, Fayetteville, AR 72703 | 2019-08-16 |
| 1306406269 | Idell Marie Mitchell | Optometrist | Eye Clinic, 1100 N College Ave, Fayetteville, AR 72703 | 2019-06-13 |
| 1821574815 | Toni Myer | Nurse Practitioner | 3 E Appleby Rd Ste 101, Fayetteville, AR 72703 | 2018-07-13 |
| 1306340393 | Josh Kelfer | Student in an Organized Health Care Education/Training Program | 1125 North College Avenue, Fayetteville, AR 72703 | 2018-03-22 |
| 1649726449 | Vantage Point of Nwa | Community/Behavioral Health | 4171 N. Crossover Rd, Fayetteville, AR 72703 | 2016-08-31 |
| 1386097137 | Jason Nordstrom | Speech-Language Pathologist | 2664 N Valencia Ave, Fayetteville, AR 72703 | 2016-07-18 |
| Find all providers in zip 72703 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477185205 | Dale A Klauss | Technician/Technologist | 294 Kenwood Rd Ste A, Fayetteville, GA 30214-3451 | 2020-02-10 |
| 1720446776 | Wal-mart Store East, Lp | Technician/Technologist | 2820 Gillespie St., Fayetteville, NC 28306 | 2016-02-05 |
| 1548653967 | National Vision, Inc. | Technician/Technologist | 105 Pavilion Pkwy, Fayetteville, GA 30214-4098 | 2015-03-10 |
| 1992082945 | Lil' Eyewear Outlet | Technician/Technologist | 120 Georgia Ave E, Fayetteville, GA 30214-1616 | 2011-11-04 |
| 1518155712 | Wavely Lee Sledge | Technician/Technologist | 160 Bienville Dr, Fayetteville, NC 28311-9335 | 2007-10-12 |
| 1518169127 | Christina Lynn Doty | Technician/Technologist | 1800 N Skibo Rd St, 148 A, Fayetteville, NC 28303 | 2007-06-05 |
| 1518183896 | Richard E Reichert | Technician/Technologist | 5924 Cliffdale Rd Ste 112a, Fayetteville, NC 28314-2100 | 2007-04-17 |
| 1184773608 | Gold Optical Enterprise Inc | Technician/Technologist | 1635 Owen Dr, Fayetteville, NC 28304-3425 | 2007-01-10 |
| 1710388210 | America's Best Contacts & Eyeglasses | Technician/Technologist | 5075 Morganton Rd, Ste 9b, Fayetteville, NC 28314-1587 | 2014-09-16 |
| 1093086159 | Patrick K Alfred | Technician/Technologist | 120 Georgia Ave E, Fayetteville, GA 30214-1616 | 2012-01-21 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 72703 |
Please comment or provide details below to improve the information on TRACI L WYATT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.