NPI | 1710530837 |
---|---|
Entity Type | Organization |
Authorized Contact | STACY THOMPSON Owner/Nurse Practitioner 307-212-6242 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
Additional Taxonomies | 207Q00000X Family Medicine |
208VP0000X Pain Medicine, Pain Medicine | |
Enumeration Date | 2019-07-17 |
Last Update Date | 2024-07-24 |