Individual
JESSICA MEENOO MAULDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
5840 E 2ND ST STE 200, CASPER, WY 82609-4363
(307) 315-6133
Mailing address
5840 E 2ND ST STE 200, CASPER, WY 82609-4363
(307) 315-6133
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
44423
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP131862
TEXAS MEDICAL LICENSE
TX
Enumeration date
02/22/2017
Last updated
08/05/2020
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