Keiffer Bengie Wyble
Clinical Nurse Specialist (Rehabilitation)

Address: 2730 Ambassador Caffery Pkwy, Lafayette, LA 70506
Phone: 3379881585

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).

Provider Overview

Nation Provider Identifier (NPI) 1083067144
Entity Type Individual
Full Name Keiffer Bengie Wyble
Credential AGACNP
Gender Male
Practice Address 2730 Ambassador Caffery Pkwy
Lafayette
LA 70506
Practice Telephone 3379881585
Practice Fax Number 3379814694
Mailing Address 2730 Ambassador Caffery Pkwy
Lafayette
LA 70506-5939
Mailing Telephone 3379881585
Mailing Fax Number 3379814694
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2016-07-13
Last Update Date 2020-01-28

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
No 363LG0600X Nurse Practitioner · Gerontology Physician Assistants & Advanced Practice Nursing Providers AP09352 LA
Yes 364SR0400X Clinical Nurse Specialist · Rehabilitation Physician Assistants & Advanced Practice Nursing Providers AP09352 LA

Other Provider Identifier

State Identifier Issuer Type Code
LA 2468685 MEDICAID

Secondary Practice Locations

Address Telephone Number Fax Number
4801 Ambassador Caffery Pkwy, Lafayette, LA 705086917 3053225100

Physician Overview

NPI 1083067144
PAC ID by PECOS 9234408774
Professional Enrollment ID I20180523000229
Full Name Keiffer Bengie Wyble
Organization Legal Name CARDIOVASCULAR INSTITUTE OF THE SOUTH, APMC
Phone Number 3379881585
Gender M
Graduation Year 2016
Primary Specialty NURSE PRACTITIONER
Group Practice PAC ID 3779497441
Number of Group Practice Members 112
Accepts Medicare Assignment Y

Taxonomy Information

Taxonomy Code 364SR0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Clinical Nurse Specialist
Specialization Rehabilitation

Taxonomy Definition

Definition to comeā€¦

Office Location

Street Address 2730 AMBASSADOR CAFFERY PKWY
City LAFAYETTE
State LA
Zip Code 70506

Providers in the same location

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
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1346887098 Hulin Urgent Care Services, LLC Clinic/Center 201 Westgate Rd, Lafayette, LA 70506 2019-12-02
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 Behavior Analyst 511 Monarch Dr, Lafayette, LA 70506 2016-12-30
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Competitor

Search similar providers

City LAFAYETTE
Zip Code 70506

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Dataset Information

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.