Organization
JACKSON WHOLE FAMILY HEALTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE L OCKER (OFFICE MANAGER)
(307) 733-7003
Entity
Organization
Contact information
Practice address
1110 MAPLE WAY, JACKSON, WY 83001
(307) 733-7003
(307) 734-8477
Mailing address
PO BOX 10738, JACKSON, WY 83002-0738
(307) 733-7003
(307) 734-8477
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00581001
BLUE CROSS
WY
Enumeration date
07/03/2007
Last updated
08/22/2020
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