Organization
STATE OF WYOMING
Active
Other names
Wyoming State Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KRISTI BARKER (BUSINESS MANAGER)
(307) 444-0721
Entity
Organization
Contact information
Practice address
251 YELLOWSTONE RIVER DR, EVANSTON, WY 82930-5340
(307) 444-0839
(307) 789-7373
Mailing address
PO BOX 177, EVANSTON, WY 82931-0177
(307) 444-0839
(307) 789-7373
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
15163
WY
283Q00000X
Psychiatric Hospital
Primary
15163
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316011562
NATIONAL PROVIDER IDENTIFIER
WY
Enumeration date
11/20/2006
Last updated
01/25/2024
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