SUSAN P WALLA

GILLETTE, WY
NPI1962589747
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner Psychiatric/Mental Health
(Licence: WY  29650.1122)
Additional Taxonomies363LP0808X Nurse Practitioner Psychiatric/Mental Health
(Licence: MT  21112)
Enumeration Date2006-11-01
Last Update Date2016-08-24
Business Address
SUSAN P WALLA APRN
707 W 8TH ST
GILLETTE, WY 82716-4108
Phone number: 307-685-8255
Mailing Address
SUSAN P WALLA APRN
748 MAIN ST
LANDER, WY 82520-3036
Phone number: 307-332-2231