Mrs Laurie Kristen Wybenga, FNP NP-C | |
222 Herlong Ave S, Rock Hill, SC 29732-1158 | |
(803) 324-3500 | |
(803) 327-8505 |
Full Name | Mrs Laurie Kristen Wybenga |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 222 Herlong Ave S, Rock Hill, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1154512382 | NPI | - | NPPES |
NP1237 | Medicaid | SC | |
346508001 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | AP127899 (Texas) | Secondary |
363LF0000X | Nurse Practitioner - Family | RX3228 (South Carolina) | Primary |
Entity Name | Piedmont Physician Network Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1194277186 PECOS PAC ID: 7911287552 Enrollment ID: O20161216001613 |
Mailing Address | Practice Location Address |
---|---|
Mrs Laurie Kristen Wybenga, FNP NP-C 7703 Floyd Curl Dr, San Antonio, TX 78229-3901 Ph: (210) 567-2788 | Mrs Laurie Kristen Wybenga, FNP NP-C 222 Herlong Ave S, Rock Hill, SC 29732-1158 Ph: (803) 324-3500 |
Mrs. Mary Jo Barreto, APRN-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: Winthrop University Health Services, Rock Hill, SC 29733 Phone: 803-323-2206 Fax: 803-323-3332 | |
Miss Kristene C Diggins, FNP, DNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 500 Lakeshore Pkwy, Rock Hill, SC 29730 Phone: 704-441-7675 | |
Ms. Wanda Kaye Clark, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1151 Camden Ave, Rock Hill, SC 29732 Phone: 803-909-6363 Fax: 803-909-6364 | |
Marta Pacheco, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1617 Shetland Ln, Rock Hill, SC 29730 Phone: 540-797-4361 | |
Andrea Blakeman, APRN Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 1131 Saluda St, Rock Hill, SC 29730 Phone: 803-325-7744 Fax: 803-325-1117 | |
Sarah Elizabeth Christ, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 170 Amendment Ave, Rock Hill, SC 29732 Phone: 803-324-7607 Fax: 800-332-4409 | |
Mr. Gerald Alfred Bracete, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 500 Lakeshore Pkwy, Rock Hill, SC 29730 Phone: 803-909-6363 |