Provider Demographics
NPI:1831580240
Name:SNOWY RANGE HEALTH CENTER
Entity type:Organization
Organization Name:SNOWY RANGE HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:B
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:307-721-2880
Mailing Address - Street 1:PO BOX 1126
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82073-1126
Mailing Address - Country:US
Mailing Address - Phone:307-460-9888
Mailing Address - Fax:307-460-9892
Practice Address - Street 1:100 S 6TH ST
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82070-3239
Practice Address - Country:US
Practice Address - Phone:307-460-9888
Practice Address - Fax:307-460-9892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-07
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty