Individual
JULIAN GOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP, PMHNP
Contact information
Practice address
510 W 29TH ST, CHEYENNE, WY 82001-2760
(330) 763-2936
(307) 637-6852
Mailing address
510 W 29TH ST, CHEYENNE, WY 82001-2760
(330) 763-2936
(307) 637-6852
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
19109.0857
WY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
19109.0857
WY
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
19109.0857
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123919800
—
WY
Enumeration date
11/10/2005
Last updated
11/09/2016
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