AMY R SURDAM

CHEYENNE, WY
NPI1629099312
Former NameAMY R FORKNER
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: WY  18161.0312)
Enumeration Date2006-07-21
Last Update Date2012-06-28
Business Address
-- AMY R SURDAM NP
433 E 19TH ST
CHEYENNE, WY 82001-4643
Phone number: 307-635-5393
Mailing Address
-- AMY R SURDAM NP
PO BOX 20170
CHEYENNE, WY 82003-7004
Phone number: 307-635-5393
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