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Betty Laura Ryba

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

56 98 Place Blvd, Hattiesburg, MS 39402-8603

PECOS Enrollment

This provider is enrolled in PECOS as BETTY RYBA.

Based on the most recent information from CMS, provider Betty Laura Ryba is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1346433430
Provider Type
Individual
Full Name
Ryba, Betty Laura
Title
Mrs.
Credential
MSN FNP-BC

Gender
Female
Sole Proprietor
Yes
Enumeration Date
8/22/2007
Last Updated
11/15/2021

Contact Information

Practice Location

56 98 Place Blvd, Hattiesburg, MS 39402-8603

(228) 596-9732

(601) 450-4640

Mailing Location

56 98 Place Blvd, Hattiesburg, MS 39402-8603

(228) 596-9732

(601) 450-4640

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License R734406 Mississippi

Provider Identifiers

ID	Description	Issuer
ID 0121027	Description Medicaid	Issuer Unlisted Mississippi

Betty Laura Ryba

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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