| NPI | 1538288766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA M MOELLER Project Director 307-232-0159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2025-09-11 |