Organization
JOHNSON COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN JARVIS RN (NURSE MANAGER)
(307) 684-2564
Entity
Organization
Contact information
Practice address
85 KLONDIKE DRIVE, BUFFALO, WY 82834-1624
(307) 684-2564
(307) 684-0744
Mailing address
PO BOX 100, BUFFALO, WY 82834-0100
(307) 684-2564
(307) 684-0744
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107260900
—
WY
Enumeration date
04/09/2007
Last updated
02/12/2009
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