Individual
MS. PATRICIA DECLUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1460 MAIN ST, LANDER, WY 82520-2657
(307) 332-2223
Mailing address
745 BUENA VISTA DR, LANDER, WY 82520-3431
(307) 332-2941
(307) 332-1920
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8949.317
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120173500
—
WY
Enumeration date
06/01/2006
Last updated
06/12/2015
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