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Individual

MRS. GABRIELE SUSANNE KNIERIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5000 BLACKMORE RD, CASPER, WY 82609-3345
(307) 233-6000
(307) 233-6089
Mailing address
5000 BLACKMORE RD, CASPER, WY 82609-3345
(307) 233-6000
(307) 233-6089

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7157A
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
120742300
WY
01
313395
BLUE CROSS
WY
01
313415
BLUE CROSS
WY
Enumeration date
01/09/2006
Last updated
09/10/2012
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