KEIFFER BENGIE WYBLE AGACNP NPI 1083067144

NPI Information

NPI: 1083067144
Provider Name: KEIFFER BENGIE WYBLE, AGACNP
Classification: Clinical Nurse Specialist - 364SR0400X
Entity Type: Individual

Specialization: Rehabilitation

Organization: CARDIOVASCULAR INSTITUTE OF THE SOUTH, APMC

PECOS Registration: Yes

Address:
2730 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA
ZIP 70506
Phone: (337) 988-1585
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Keiffer Bengie Wyble, AGACNP is a rehabilitation clinical nurse specialist in Lafayette, LA with 8 years of experience. Keiffer Bengie Wyble, AGACNP NPI is 1083067144. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2730 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA
ZIP 70506
Phone: (337) 988-1585
Fax: (337) 981-4694

The NPI 1083067144 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/13/2016 and was last updated on 1/8/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		AP09352	LOUISIANA	No
2	363LG0600X	Nurse Practitioner	Gerontology	AP09352	LOUISIANA	No
3	364SR0400X	Clinical Nurse Specialist	Rehabilitation	AP09352	LOUISIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2468685	MEDICAID	LOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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