P Praxis·MD
● Active Type 1 · Individual

Myllissa M. Wyatt, NP

Nurse Practitioner·Salmon, ID· NPI 1730439266 · Enumerated 2012 · 13 years on NPI
Wyatt is 1 of 6 nurse practitioner providers in Salmon and 1 of 1280 in Idaho.
NPI age
13 years
Enumerated 2012-09-12
Primary specialty
Nurse Practitioner
Plus 1 subspecialty
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2025-01-22
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file

How this provider compares

Across 1280 active nurse practitioner providers in Idaho.

NPI age
13 years
↑ 6 yr above median (7 yr)
State licenses
1 state
13% of peers hold multiple states
Subspecialties
1
In the 27% of peers with subspecialties

NPI lifetime · 2012 → 2026

2012-09Enumerated in NPPES
2012 2026

Where they practice

Practice location
403 Riverfront Dr
Salmon, ID 834675162
📞 2087421110fax 2087421120
Mailing address
403 Riverfront Dr
Salmon, ID 834675162
📞 2087421110fax 2087421120

Specialties

  • Nurse Practitioner Primary
    Definition to come...
    ID license #NP-1202A taxonomy 363LF0000X
  • Nurse Practitioner
    (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum...
    ID license #1202A taxonomy 363L00000X

Identifiers

TypeValueNotes
05 (ID) IDTPID011077

Practice context

Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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