Paengsri Marie Dryburg

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R0083497 Issued in OK

Practice address

602 SW 38TH St
Lawton, OK 73505-6912

Phone

(580) 248-5780

NPI assigned

Dec 9, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Paengsri Marie Wilder, Bowman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1467163584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 SW 38TH ST",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056912",
            "telephone_number": "580-248-5780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 SW 38TH ST",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056912",
            "telephone_number": "580-248-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRYBURG",
        "first_name": "PAENGSRI",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-09",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "R0083497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAENGSRI",
            "last_name": "WILDER, BOWMAN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chirobi Draper-Hill
• Courtney Drevo, R.D./L.D.
• Robert Drewry
• Anna Driggers
• David Joseph Drummond, D.D.S.
• Dscruggs, NP, PLLC
• Doris Dualan, RN
• Vincent Dubose
• Creeana Dubray
• Lisa Dubray, LPN

• Registered Nurse in Lawton, OK
• Providers in Lawton, OK by specialty
• Registered Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.