IndividualActive
Diane Wyatt, MSN, RN, AGCNS-BC
NPI 1376110080 · Gerontology Clinical Nurse Specialist · Wyandotte, MI
Provider details
- NPI number
- 1376110080
- Entity type
- Individual
- Primary specialty
- Gerontology Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- MSN, RN, AGCNS-BC
- Sex
- Female
- Sole proprietor
- No
- License
- 2018079552 (MI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone: (734) 246-9865
Approximate (ZIP-level) locationGet directions
Mailing address
11776 Commerce Rd
Brighton, MI 48114-9650
Registry dates
- Enumerated
- 2021-06-10
- Last updated
- 2021-06-10
- Certified
- 2021-06-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.