Individual ProviderSharla Louise WyattRegistered NurseNursing Service ProvidersPractice Address4212 N 16th St, Phoenix, AZ 85016-5319(602) 263-1200(602) 200-5383PECOS EnrollmentBased on the most recent information from CMS, provider Sharla Louise Wyatt does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1003208299Provider TypeIndividualFull NameWyatt, Sharla LouiseCredentialRNGenderFemaleSole ProprietorNoEnumeration Date2/24/2015Last Updated2/24/2015Contact InformationPractice LocationPractice Address4212 N 16th St, Phoenix, AZ 85016-5319Phone(602) 263-1200FaxUnlisted FaxMailing LocationMailing AddressPO Box 310010698, Pasadena, CA 91110-0698Phone(602) 200-5383FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense698560CaliforniaCode163W00000XDescriptionRegistered NurseNursing Service ProvidersLicenseRN167505Arizona