Individual
SALLY RAFERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
204 MCCOLLUM ST STE 104, LARAMIE, WY 82070-5151
(307) 745-0085
Mailing address
5807 BASTION RD, LARAMIE, WY 82070-8236
(307) 745-0085
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
55013
WY
363LF0000X
Family Nurse Practitioner
Primary
AP61454942
WA
Other
Enumeration date
07/03/2023
Last updated
04/11/2026
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