# WIND RIVER OBSTETRICS AND GYNECOLOGY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992744817
- **Authorized official:** MARYANNE A HANNANEY MD (CEO)
- **Authorized official phone:** (307) 857-3488

## Contact information

- **Practice address:** 1005 COLLEGE VIEW DR, RIVERTON, WY 82501-2266
- **Practice address phone:** (307) 857-5217
- **Practice address fax:** (307) 857-5215
- **Mailing address:** 1005 COLLEGE VIEW DR, RIVERTON, WY 82501-2289
- **Mailing address phone:** (307) 856-4232
- **Mailing address fax:** (307) 856-4243

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 6798A | WY | Yes |

## Other

- **Enumeration date:** 06/06/2006
- **Last updated:** 05/31/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 118601900 | — | WY |