WYATT MATTHEW GARDNER AGACNP NPI 1720799091

NPI Information

  • NPI: 1720799091
  • Provider Name: WYATT MATTHEW GARDNER, AGACNP
  • Classification: Nurse Practitioner - 363L00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1 MEDICAL CENTER DR
    MORGANTOWN, WV
    ZIP 26506
  • Phone: (304) 598-6194

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NPI Details

Wyatt Matthew Gardner, AGACNP is a nurse practitioner in Morgantown, WV with 4 years of experience. The provider is (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 or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. Wyatt Matthew Gardner, AGACNP NPI is 1720799091. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: DREXEL UNIVERSITY COLLEGE OF MEDICINE
Graduation Year:2022

The provider's business location address is:

1 MEDICAL CENTER DR
MORGANTOWN, WV
ZIP 26506-200
Phone: (304) 598-6194

The NPI 1720799091 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/7/2022 and was last updated on 4/1/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse Practitioner114813WASHINGTONNo
2363LA2100XNurse PractitionerAcute Care114813WEST VIRGINIANo
3363LC0200XNurse PractitionerCritical Care Medicine114813WEST VIRGINIANo
4363L00000XNurse PractitionerAPRN11035167FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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