Organization
WYOMING NEUROLOGY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY J FARRIS FNP (FNP)
(307) 432-0335
Entity
Organization
Contact information
Practice address
2301 HOUSE AVE, STE 203, CHEYENNE, WY 82001-3176
(307) 432-0335
(307) 432-0341
Mailing address
2301 HOUSE AVE, STE 203, CHEYENNE, WY 82001-3176
(307) 432-0335
(307) 432-0341
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
159020190
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1156560 01
—
WY
Enumeration date
01/22/2007
Last updated
06/23/2008
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