| NPI | 1205345931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA ACKER CEO 307-352-6677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2022-07-21 |