KEIFFER BENGIE WYBLE (NPI# 1083067144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083067144 |
| Entity Type | Individual |
| Full Name | KEIFFER BENGIE WYBLE |
| Credential | AGACNP |
| Practice Address |
2730 Ambassador Caffery Pkwy Lafayette LA 70506 |
| Mailing Address |
2730 Ambassador Caffery Pkwy Lafayette LA 70506-5939 |
| Practice Telephone | 3379881585 |
| Practice Fax Number | 3379814694 |
| Mailing Telephone | 3379881585 |
| Mailing Fax Number | 3379814694 |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2020-01-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
AP09352 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 364SR0400X |
Clinical Nurse Specialist Specialization: Rehabilitation |
AP09352 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2468685 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4801 Ambassador Caffery Pkwy, Lafayette, LA 705086917 | 3053225100 |
| Street Address |
2730 AMBASSADOR CAFFERY PKWY |
| City | LAFAYETTE |
| State | LA |
| Zip Code | 70506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922005768 | Mitchell David Lirtzman | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2730 Ambassador Caffery Pkwy, Lafayette, LA 70506-5904 | 2005-07-07 |
| 1902269509 | Rein Liles | Nurse Practitioner | 2730 Ambassador Caffery Pkwy, Lafayette, LA 70506-5939 | 2016-03-31 |
| 1659764041 | John-mario Walter Altamirano | Nurse Practitioner | 2730 Ambassador Caffery Pkwy, Lafayette, LA 70506-5939 | 2015-03-10 |
| 1619368586 | Marcus A Montet | Nurse Practitioner | 2730 Ambassador Caffery Pkwy, Lafayette, LA 70506-5939 | 2015-02-12 |
| 1063796407 | Mareesa Perrault Mathers | Nurse Practitioner | 2730 Ambassador Caffery Pkwy, Lafayette, LA 70506-5939 | 2011-10-04 |
| 1871881698 | Acadiana Endocrinology Clinic LLC | Internal Medicine | 2730 Ambassador Caffery Pkwy, 201, Lafayette, LA 70506-5939 | 2011-07-13 |
| 1710207725 | Brent Lee Smith | Nurse Practitioner | 2730 Ambassador Caffery Pkwy, Lafayette, LA 70506-5939 | 2010-06-02 |
| 1144458027 | Amit Navinchandra Amin | Internal Medicine | 2730 Ambassador Caffery Pkwy, Lafayette, LA 70506-5939 | 2009-06-30 |
| 1255568481 | Gabe Scott Robin | Nurse Practitioner | 2730 Ambassador Caffery Pkwy, Lafayette, LA 70506-5939 | 2009-06-15 |
| 1265674691 | Krishna Nagendran | Internal Medicine | 2730 Ambassador Caffery Pkwy, Lafayette, LA 70506-5939 | 2009-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417421447 | Maranda Washington | Student in an Organized Health Care Education/Training Program | 202 Reinhardt Drive, Lafayette, LA 70506 | 2019-01-12 |
| 1447742473 | Glenda Gravouilla Poulan | Driver | 330 Guilbeau Rd, Lafayette, LA 70506 | 2018-06-05 |
| 1194215905 | Angelica Plumbar | Case Manager/Care Coordinator | 1304 Bertrand Dr Ste B21304, Lafayette, LA 70506 | 2018-05-16 |
| 1801394820 | Acadiana Ambulatory Health Care Services | Non-Pharmacy Dispensing Site | 207 Westmark Blvd., Lafayette, LA 70506 | 2018-01-24 |
| 1578070041 | Kimberly Lois Robinson | Counselor | 203 Pinto St, Lafayette, LA 70506 | 2018-01-05 |
| 1558890814 | Shanece Marie Solomon | Speech-Language Pathologist | 326 Guilbeau Rd Apt 240, Lafayette, LA 70506 | 2017-06-08 |
| 1225565625 | Keena Lewis | Case Manager/Care Coordinator | 121 Kohen Luke Dr, Lafayette, LA 70506 | 2017-05-16 |
| 1326571498 | Natasha Deville | Community/Behavioral Health | 1408 W Willow St 162, Lafayette, LA 70506 | 2017-04-06 |
| 1952846826 | Mia D Arthur | Behavioral Analyst | 511 Monarch Dr, Lafayette, LA 70506 | 2016-12-30 |
| 1265983340 | Eric Prince | Specialist/Technologist | 202 Reinhardt Dr., Lafayette, LA 70506 | 2016-10-24 |
| Find all providers in zip 70506 | ||||
| Taxonomy Code | 364SR0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Rehabilitation |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.