| NPI | 1629320775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTA L BLOUGH Psychiatric Mental Health Nurse Pra 307-764-4130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WY 19373.1191) |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2013-05-16 |