| NPI | 1659949683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARANNA SHARMEL JOHNSON Nurse Practitioner 307-461-5080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2021-06-16 |