Individual
LANE WYBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2408 BROADMOOR BLVD STE B, MONROE, LA 71201-2994
(318) 807-0525
(318) 807-1077
Mailing address
130 DESIARD ST STE 355, MONROE, LA 71201-7363
(318) 807-7875
(318) 812-6603
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN136523
LA
363LF0000X
Family Nurse Practitioner
Primary
206936
LA
Other
Enumeration date
04/29/2019
Last updated
08/07/2019
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