Individual
MRS. DAOREUANG DEEDEY KIDNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3632 AMERICAN WAY, CASPER, WY 82604-3164
(307) 233-7300
Mailing address
3114 E 1ST ST, CASPER, WY 82609-2137
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
44378
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44378
WYOMING STATE BOARD OF NURSING
WY
Enumeration date
08/06/2019
Last updated
11/27/2023
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