| NPI | 1154633048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN NOLAN President 307-690-4111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WY 15711.0192) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2016-06-09 |