Wybenga, Laurie Kristen

Wybenga, Laurie Kristen is an individual health care provider with primary practice located at 222 Herlong Ave S , Rock Hill SC 29732-1158. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wybenga, Laurie Kristen can be contacted via phone (803) 324-3500.

Contact Information

Primary practice address
222 Herlong Ave S Rock Hill SC 29732-1158
Phone: (803) 324-3500
Fax: (803) 327-8505
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP127899 Texas
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RX3228 South Carolina

Profile Details

NPI number 1154512382
LBN Legal business name Wybenga, Laurie Kristen
Credentials FNP NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2007
Last updated Sep 26th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154512382 NPPES
South Carolina MEDICAID NP1237
South Carolina MEDICAID 346508001

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