Provider Demographics
NPI:1134495195
Name:FREMONT COUNTY FAMILY PLANNING
Entity type:Organization
Organization Name:FREMONT COUNTY FAMILY PLANNING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FAMILY PLANNING
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:TWIST
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:307-332-1073
Mailing Address - Street 1:450 N 2ND ST
Mailing Address - Street 2:ROOM 350
Mailing Address - City:LANDER
Mailing Address - State:WY
Mailing Address - Zip Code:82520-2302
Mailing Address - Country:US
Mailing Address - Phone:307-332-1073
Mailing Address - Fax:307-332-1064
Practice Address - Street 1:325 W MAIN ST
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:WY
Practice Address - Zip Code:82501-3448
Practice Address - Country:US
Practice Address - Phone:307-856-7212
Practice Address - Fax:307-857-1595
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FREMONT COUNTY GOVERNMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY15714261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility