Organization
STATE OF WYOMING
Active
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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