Individual
KYLE LESLIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1035 ROSE LN, RIVERTON, WY 82501-2286
(307) 463-6300
Mailing address
5000 BLACKMORE RD, CASPER, WY 82609-3345
(307) 233-6000
(307) 233-6089
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
48431
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212235900
—
WY
Enumeration date
03/25/2016
Last updated
03/08/2024
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