WYLETTA PETTIT


Address: 607 N Polk Ave, Wagoner, OK 74467-2713
Phone: 9183044371

WYLETTA PETTIT (NPI# 1851867014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1851867014
Entity Type Individual
Full Name WYLETTA PETTIT
Practice Address 607 N Polk Ave
Wagoner
OK 74467-2713
Practice Telephone 9183044371
Mailing Telephone 9183044371
Enumeration Date 2018-10-15
Last Update Date 2018-10-15
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 175T00000X Peer Specialist Other Service Providers

Office Location

Street Address 607 N POLK AVE
City WAGONER
State OK
Zip Code 74467-2713

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1982251591 Alesha Lenard Behavior Technician 901 S. Harrill Ave, Wagoner, OK 74467 2019-08-20
1679030597 Lorri Dawn Pitchford Case Manager/Care Coordinator Creoks Behavioral Health Services, 109 S Harrill Ave., Wagoner, OK 74467 2019-02-27
1144769399 Elaina Murray Technician 308 Ne 2nd St., Wagoner, OK 74467 2017-02-21
1336699784 Tommye Evidson Counselor 109 Harrill Ave, Wagoner, OK 74467 2016-10-10
1518327857 Yco Tulsa, Inc Clinic/Center 1101a South Mcquarrie, Wagoner, OK 74467 2016-02-29
1396117545 Sandra Cooper Behavioral Analyst 2109 Us-69, Wagoner, OK 74467 2015-10-28
1588051486 Penny Nye Counselor 2109 S.hwy 69, Wagoner, OK 74467 2015-04-20
1376943571 Justin F Kurtz Respiratory Therapist, Certified 1200 W. Cherokee, Suite H Cardiac/pulmonary Rehab, Wagoner, OK 74467 2014-08-26
1780009969 David H Good Family Medicine 1202 W. Cherokee St, Ste E, Wagoner, OK 74467 2014-02-25
1942598875 Robin Rodriguez-higginbottom Speech-Language Pathologist 215 E Cherokee St, Wagoner, OK 74467 2011-07-12
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Taxonomy Information

Taxonomy Code 175T00000X
Grouping Other Service Providers
Classification Peer Specialist

Taxonomy Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
Notes: Source: National Uniform Claim Committee [7/1/2014: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1578101002 Lanica Willaby Peer Specialist 307 E Cherokee St, Wagoner, OK 74467-4729 2019-12-16
1275051708 Lexie Jo Wells Peer Specialist 26243 State Highway 51, Wagoner, OK 74467-8740 2017-09-05
1013381334 Nancy Thomasson Peer Specialist 300 S Sprague Ave, Wagoner, OK 74467-5418 2015-11-24
1053882175 Mark Walters Peer Specialist 26243 State Highway 51, Wagoner, OK 74467-8740 2018-12-16
1679083166 Karyn Elizabeth Fox Peer Specialist 2109 S Highway 69, Wagoner, OK 74467-9310 2017-10-10
1457878555 Stephanie Ann Ferrer Peer Specialist 109 S Harrill Ave, Wagoner, OK 74467-5317 2017-08-29

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1659972537 Tamra Lynn Cunningham Peer Specialist 764 Sherwin Ave, Ponca City, OK 74604-6112 2020-11-05
1699375691 Martha Isabel Zapata Peer Specialist 5740 E 72nd Ct, Tulsa, OK 74136-7202 2020-10-28
1376143883 Tina Marie Lopez Peer Specialist 933 N Oak St, Ponca City, OK 74601-3218 2020-10-26
1518566264 Vincent Oaks Cox Peer Specialist 3585 S 439, Pryor, OK 74361-9346 2020-10-23
1558960146 Sarah Elizabeth Walters Peer Specialist 2139 W Jasper St Apt B1, Broken Arrow, OK 74011-8028 2020-10-23
1861091548 Ryan Vanmeter Peer Specialist 1965 Ladera Ln, Edmond, OK 73034-9787 2020-10-22
1255930038 Brandon Loyd Hopkins Peer Specialist 446 S Scraper St, Vinita, OK 74301-4250 2020-10-22
1225637366 Crystal Dawn Adams Peer Specialist 200 N Sante Fe Ave, Bartlesville, OK 74003 2020-10-20
1194324491 Judith Anne Young Peer Specialist 3934 Se 27th St, Del City, OK 73115-2620 2020-10-19
1407455892 Kristen Michelle Stock Peer Specialist 804 N Dryden Cir, Stillwater, OK 74075-7108 2020-10-18
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Competitor

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City WAGONER
Zip Code 74467

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Dataset Information

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.

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