| NPI | 1942969787 |
|---|---|
| Other Name | SUPPORTIVE (PALLIATIVE) CARE |
| Entity Type | Organization |
| Authorized Contact | ERIN PETERSEN Payer Enrollment Specialist 307-432-3664 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine |
| 363L00000X Nurse Practitioner | |
| 363LA2100X Nurse Practitioner, Acute Care | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| 207Q00000X Family Medicine | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2021-12-09 |
| Last Update Date | 2025-09-16 |