| NPI | 1386407963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA SUE WALKER Owner 307-679-1286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2024-03-04 |