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Individual

MRS. DEBORAH SUSAN BRACKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
214 E 23RD ST, CHEYENNE, WY 82001-3748
(307) 432-6629
(307) 432-6634
Mailing address
PO BOX 20970, CHEYENNE, WY 82003-7020
(307) 996-4777

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7748A
WY
208M00000X
Hospitalist Physician
7748A
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1306978580
WY
Enumeration date
03/12/2007
Last updated
07/05/2021
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