Organization
EQUALITY STATE INFECTION FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA MARIE WILLETTE RN (COO, CFO)
(307) 234-8710
Entity
Organization
Contact information
Practice address
5810 E 2ND ST STE 200, CASPER, WY 82609-4330
(307) 234-8710
(307) 237-0326
Mailing address
5810 E 2ND ST STE 200, CASPER, WY 82609-4330
(307) 234-8710
(307) 237-0326
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
133V00000X
Registered Dietitian
—
—
163WC0400X
Case Management Registered Nurse
—
—
207RI0200X
Infectious Disease Physician
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
12/18/2008
Last updated
12/18/2008
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