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BEREVON TAYSHAWN WYATT
NPI 1114526068
Massage Therapist in Milwaukee, WI

Active since October 21, 2020
3510 N OAKLAND AVE STE 206, MILWAUKEE, WI 53211(414) 915-4213 Get Directions Write a Review

NPPES record last updated: October 21, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Berevon Tayshawn Wyatt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BEREVON TAYSHAWN WYATT (NPI 1114526068) is an individual massage therapist in Milwaukee, Wisconsin, licensed in Wisconsin (14485-146) and active in the NPI registry since October 2020.

NPPES Registry Identity

NPI1114526068
Entity TypeIndividualMale
Primary Taxonomy225700000X
Provider Legal NameBEREVON TAYSHAWN WYATT
Location Address3510 N OAKLAND AVE STE 206Milwaukee, WI 53211-2746
Mailing Address1727 W Keefe AveMilwaukee, WI 53206-2322 · (414) 915-4213
Phone(414) 915-4213
Sole ProprietorYes
Enumeration DateOctober 21, 2020
NPPES CertifiedOctober 21, 2020
✔ NPI 1114526068 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in WI · 14485-146
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
3510 N OAKLAND AVE STE 206, Milwaukee, WI 53211
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Berevon Wyatt's NPI number?

The NPI number for Berevon Wyatt is 1114526068. It was assigned to this individual provider in the NPPES registry on October 21, 2020.

Where is Berevon Wyatt located?

Berevon Wyatt practices at 3510 N Oakland Ave Ste 206, Milwaukee, WI 53211. The listed phone number is (414) 915-4213.

What is Berevon Wyatt's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Berevon Wyatt was last updated on October 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.