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Individual

MRS. SUE ELLEN TARDIF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BSN

Contact information

Practice address
1812 SILVER SPUR RD, CHEYENNE, WY 82009-1208
(307) 421-0396
Mailing address
1812 SILVER SPUR RD, CHEYENNE, WY 82009-1208
(307) 421-0396

Taxonomy

Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
19148
WY
163WH1000X
Hospice Registered Nurse
19148
WY

Other

Enumeration date
06/27/2012
Last updated
06/27/2012
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