| NPI | 1154529303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY ANN NICKSICH Nurse Practitioner 307-362-6813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: WY 8026.0216) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2007-07-12 |