Provider Demographics
NPI:1104910066
Name:WYATT, MARIE SCHULTHEIS (APRN)
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:SCHULTHEIS
Last Name:WYATT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:MARIE
Other - Middle Name:MARGARET
Other - Last Name:SCHULTHEIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3434 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6208
Mailing Address - Country:US
Mailing Address - Phone:504-507-5744
Mailing Address - Fax:405-456-7481
Practice Address - Street 1:3434 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6208
Practice Address - Country:US
Practice Address - Phone:504-507-5744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA099809163WP0809X
LARN099809-AP05092364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult