Individual
KELLY GEBAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP-BC
Contact information
Practice address
611 E CARLSON ST STE 102, CHEYENNE, WY 82009-4335
(307) 364-3415
(307) 296-0349
Mailing address
611 E CARLSON ST STE 102, CHEYENNE, WY 82009-4335
(307) 364-3415
(307) 296-0349
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
22963
WY
363L00000X
Nurse Practitioner
47173
WY
363LW0102X
Women's Health Nurse Practitioner
Primary
47173
WY
Other
Enumeration date
05/22/2020
Last updated
01/24/2025
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