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Organization

FAMILY CARE CLINIC, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TERI JEAN OURADA DNP, APRN-C (OWNER)
(307) 745-0085
Entity
Organization

Contact information

Practice address
204 MCCOLLUM ST STE 104, LARAMIE, WY 82070-5151
(307) 745-0085
(307) 745-0084
Mailing address
204 MCCOLLUM ST STE 104, LARAMIE, WY 82070-5151
(307) 745-0085
(307) 745-0084

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
118524100
WY
01
53D1012895
CLIA
WY
Enumeration date
02/15/2007
Last updated
04/30/2023
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