Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kelly Wyatt

Individual provider Pulmonary Disease Physician · NPI 1033756044

Kelly Wyatt is a Nurse Practitioner in Salem, New Jersey. Qualified in 2019, 7 years ago. Practices with Main Line Healthcare, a 1,153-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New Jersey and Pennsylvania.

Years since qualifying
7
Licensed in
NJ, PA
In the registry since
2019
Specialties on file
3

Practice location Address checks out

4 Bypass Rd Ste 104
Salem, NJ 08079-2053
Phone: (610) 619-7460
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 100 E Lancaster Ave, Wynnewood, PA 19096-3450 — (484) 572-0171

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 26NJ00996800 (NJ)
Pulmonary Disease Physician Taxonomy 207RP1001X · Licence 26NJ00996800 (NJ)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence SP024697 (PA)

Record details

NPI number1033756044
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 9, 2019
Last updated in NPPESJuly 1, 2026
Certification dateJuly 1, 2026
Mailing address333 Hickory Ave, Aston, PA 19014-1100

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Main Line Healthcare — 1153 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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