NPI | 1235282120 |
---|---|
Entity Type | Organization |
Authorized Contact | TRACY J FARRIS Fnp 307-432-0335 |
Organization Subpart ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WY 159020190) |
Enumeration Date | 2007-01-22 |
Last Update Date | 2008-06-23 |