Facts
- Status
- A
- Credential
- RN
- Type
- Individual
- Enumeration date
- 2009-01-07
- Last updated
- 2009-01-07
Licenses
- License WY
- 21481
- License WY
- 21481
Location
- Practice location
- 1841 MADORA AVE
- City
- DOUGLAS WY
- Postal code
- 826333057
- Phone
- 307-358-2846
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.