AMY MARIE WYBENGA (NPI# 1093896540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093896540 |
| Entity Type | Individual |
| Full Name | AMY MARIE WYBENGA |
| Credential | CRNP |
| Practice Address |
564 N Memorial Dr Prattville AL 36067-2132 |
| Mailing Address |
2257 Taylor Rd Suite 200 Montgomery AL 36117-7790 |
| Practice Telephone | 3343582010 |
| Practice Fax Number | 3343582013 |
| Mailing Telephone | 3342709914 |
| Mailing Fax Number | 3342703195 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WG0000X |
Registered Nurse Specialization: General Practice |
1-061747 | AL | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | BLUE CROSS | 51533030 | 01 |
| Street Address |
564 N MEMORIAL DR |
| City | PRATTVILLE |
| State | AL |
| Zip Code | 36067-2132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710998505 | Wybenga Family Healthcare, Inc. | Family Medicine | 564 N Memorial Dr, Prattville, AL 36067-2132 | 2006-08-10 |
| 1770861544 | Wendy Mcfarland Cavey | Nurse Practitioner | 564 N Memorial Dr, Prattville, AL 36067-2132 | 2011-07-28 |
| 1063644623 | Jennifer Hagan Mann | Nurse Practitioner | 564 N Memorial Dr, Prattville, AL 36067-2132 | 2009-08-17 |
| 1902987555 | Maarten A Wybenga | Family Medicine | 564 N Memorial Dr, Prattville, AL 36067-2132 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316352552 | Agape Me LLC | Case Manager/Care Coordinator | 353 Bent Tree Dr., Prattville, AL 36067 | 2014-06-26 |
| 1770868671 | Susan Elizabeth Swink | Pharmacist | 703 South Memorial Dr, Walgreens Pharmacy, Prattville, AL 36067 | 2011-10-12 |
| 1255501458 | Edwin R. Mullins | Dentist | 268 1st St., Prattville, AL 36067 | 2008-03-04 |
| 1598891046 | James Ronald Roberson Sr. | Dentist | 113 E Main, Prattville, AL 36067 | 2007-02-26 |
| 1326184029 | Prattville Primary Care LLC | Family Medicine | 461 E Main Street, Prattville, AL 36067 | 2007-01-29 |
| 1669591418 | Walter Eugene Parker | Family Medicine | 107 Quail Run, Prattville, AL 36067 | 2007-03-29 |
| 1376582049 | James Daniel Cartwright | Internal Medicine | 808 Durden Rd, Prattville, AL 36067-1533 | 2006-06-06 |
| 1386162816 | Logan Elizabeth Dodd | Speech-Language Pathologist | 815 Durden Rd, Prattville, AL 36067-1534 | 2017-09-05 |
| 1891182200 | Steve Weedon | Specialist/Technologist | 1218 Kingston Garden Rd, Prattville, AL 36067-1704 | 2015-04-23 |
| 1780042887 | James K Nichols Jr. | Nurse Anesthetist, Certified Registered | 101 Coleman Dr, Prattville, AL 36067-1766 | 2016-02-03 |
| Find all providers in zip 36067 | ||||
| Taxonomy Code | 163WG0000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900557 | Shean Polony | Registered Nurse | 138 Bridgemill Ave, Madison, AL 35756-2619 | 2020-10-23 |
| 1932729399 | Amelia Garrett Williamson | Registered Nurse | 1813 Le Grande Dr, Mobile, AL 36618-1622 | 2020-04-25 |
| 1053950337 | Deanna Brewer Morrison | Registered Nurse | 535 Jack Warner Pkwy Ne Ste K, Tuscaloosa, AL 35404-5715 | 2020-01-03 |
| 1144883232 | Kay-ann Nickeisha Mclean | Registered Nurse | 250 Chateau Dr Sw Ste 215, Huntsville, AL 35801-3497 | 2019-04-15 |
| 1053833855 | Robin J Marks | Registered Nurse | 5332 Wilhelm Dr, Mobile, AL 36618-2428 | 2017-07-13 |
| 1255720348 | Angela Rene' Pontius | Registered Nurse | Zrb 239, 1720 2nd Avenue South, Birmingham, AL 35294-0007 | 2015-01-13 |
| 1477804425 | Lucille Denise Rudolph | Registered Nurse | 659 Oak Hill Rd, Mobile, AL 36609-5914 | 2012-09-29 |
| 1932491131 | Ramsey Paulk Shubert | Registered Nurse | 340 Cox Blvd, Sheffield, AL 35660-4020 | 2011-05-05 |
| 1366043226 | Tiffany Sanquits Fields | Registered Nurse | 2400 Hospital Rd, Tuskegee, AL 36083-5001 | 2020-11-05 |
| 1568061422 | Genesis Morgan | Registered Nurse | 1802 6th Ave S, Birmingham, AL 35233-1932 | 2020-10-21 |
| Find all providers with the same taxonomy | ||||
| City | PRATTVILLE |
| Zip Code | 36067 |
Please comment or provide details below to improve the information on AMY MARIE WYBENGA.
| 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.