Active NPI
Mary Claire Wyble, LN
- Nutritionist
- Saint Paul, MN
National Provider Identifier
1801081815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- N121
- Practice address
- 860 Arcade St
Saint Paul, MN 55106-3852 - Phone
- (651) 793-2243
- Fax
- (651) 312-1982
- NPI assigned
- Sep 12, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | N121 | MN | Primary |
Addresses
Primary practice location
860 Arcade St
Saint Paul, MN 55106-3852
Mailing address
860 Arcade St
Saint Paul, MN 55106-3852
Phone (651) 793-2243
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N121 | MN | MD | Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189555200000",
"number": "1801081815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "860 ARCADE ST",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551063852",
"telephone_number": "651-793-2243",
"fax_number": "651-312-1982"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "860 ARCADE ST",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551063852",
"telephone_number": "651-793-2243",
"fax_number": "651-312-1982"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYBLE",
"first_name": "MARY CLAIRE",
"credential": "LN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-12",
"last_updated": "2007-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "MN",
"license": "N121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.