Individual
MRS. TRACI DENISE DARNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
497 W LOTT ST, BUFFALO, WY 82834-1609
(307) 684-2228
(307) 684-2177
Mailing address
497 WEST LOTT, BUFFALO, WY 82834-1609
(307) 684-2228
(307) 684-2177
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
280
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11811730
—
WY
01
—
313751
BLUE CROSS
WY
Enumeration date
01/12/2006
Last updated
08/01/2007
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