Provider Demographics
NPI:1346532066
Name:WYBORNY, CHRISTI JO (RN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTI
Middle Name:JO
Last Name:WYBORNY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:CHRISTI
Other - Middle Name:JO
Other - Last Name:WYBORNY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1010 BALSAM AVE
Mailing Address - Street 2:
Mailing Address - City:NORA SPRINGS
Mailing Address - State:IA
Mailing Address - Zip Code:50458-8030
Mailing Address - Country:US
Mailing Address - Phone:641-903-8266
Mailing Address - Fax:
Practice Address - Street 1:1010 BALSAM AVE
Practice Address - Street 2:
Practice Address - City:NORA SPRINGS
Practice Address - State:IA
Practice Address - Zip Code:50458-8030
Practice Address - Country:US
Practice Address - Phone:641-903-8266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1664490163W00000X
IA066748163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse