IndividualActive
Ebony Wyatt, CPT
NPI 1902772148 · Technician · Columbia, MS
Provider details
- NPI number
- 1902772148
- Entity type
- Individual
- Primary specialty
- TechnicianNursing Service Related Providers
- Credential
- CPT
- Sex
- Female
- Sole proprietor
- Yes
- License
- Z6Y4T5D7 (MS)
Specialties & taxonomies
Nursing Service Related Providers
Practice location
811 Main St Ste 17
Columbia, MS 39429-2711
Phone: (601) 549-3006
Approximate (ZIP-level) locationGet directions
Mailing address
102 Lexington Dr
Hattiesburg, MS 39402-9313
Registry dates
- Enumerated
- 2025-10-15
- Last updated
- 2025-10-15
- Certified
- 2025-10-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.