Individual
MRS. LAURIE KRISTEN WYBENGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP NP-C
Contact information
Practice address
222 HERLONG AVE S, ROCK HILL, SC 29732-1158
(803) 324-3500
(803) 327-8505
Mailing address
7703 FLOYD CURL DR, SAN ANTONIO, TX 78229-3901
(210) 567-2788
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP127899
TX
363LF0000X
Family Nurse Practitioner
Primary
RX3228
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
346508001
—
TX
05
—
NP1237
—
SC
Enumeration date
08/05/2007
Last updated
09/26/2022
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