Individual
MS. ELLICIA RAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2360 E PERSHING BLVD, CHEYENNE, WY 82001-5356
(307) 778-7550
Mailing address
3539 LUTHER PL, CHEYENNE, WY 82001-1766
(303) 915-5087
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
49101
CO
164W00000X
Licensed Practical Nurse
8251
WY
164W00000X
Licensed Practical Nurse
Primary
L15574
ND
164W00000X
Licensed Practical Nurse
T14433
ND
Other
Enumeration date
08/26/2024
Last updated
08/26/2024
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