Provider Demographics
NPI:1821157363
Name:WYSONG, CHRISTINE KYONG (RNPMHNP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:KYONG
Last Name:WYSONG
Suffix:
Gender:F
Credentials:RNPMHNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1604 HOSPITAL PKWY
Mailing Address - Street 2:#507
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-6986
Mailing Address - Country:US
Mailing Address - Phone:817-354-7268
Mailing Address - Fax:817-354-9930
Practice Address - Street 1:1604 HOSPITAL PKWY
Practice Address - Street 2:#507
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6986
Practice Address - Country:US
Practice Address - Phone:817-354-7268
Practice Address - Fax:817-354-9930
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX677843363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health