Organization
THERESA LERCH C FNP CNM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA LERCH C-FNP, CNM (PRESIDENT)
(307) 733-4585
Entity
Organization
Contact information
Practice address
320 E BROADWAY, SUITE 1C, JACKSON, WY 83001
(307) 733-4585
(307) 733-4787
Mailing address
PO BOX 9487, JACKSON, WY 83002-9487
(307) 733-4585
(307) 733-4787
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
18054.0164
WY
367A00000X
Advanced Practice Midwife
18054.0164
WY
Other
Enumeration date
01/16/2008
Last updated
12/03/2008
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