Individual
JESUS TACHIQUIN-FRIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1263 N 15TH ST, LARAMIE, WY 82072-2343
(307) 745-8915
Mailing address
1263 N 15TH ST, LARAMIE, WY 82072-2343
(307) 745-8915
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
25440
WY
172V00000X
Community Health Worker
—
—
Other
Enumeration date
07/29/2011
Last updated
02/01/2012
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