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Individual
LARAE SUZANNE MCCARDELL
Active
Individual
LARAE SUZANNE MCCARDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
22146-1023
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116LH09
WYOMING CONTROLLED SUBSTANCE REGISTRATION
WY
01
—
W23006
MEDICARE PTAN
WY
Enumeration date
09/21/2009
Last updated
03/13/2023
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