Individual
MRS. JACQUELINE GALE RETHERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS NP
Contact information
Practice address
111 S 5TH ST, DOUGLAS, WY 82633-2434
(307) 358-7300
Mailing address
111 S 5TH ST, DOUGLAS, WY 82633-2434
(307) 358-7300
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
NP 19602
CA
Other
Enumeration date
07/12/2010
Last updated
12/20/2016
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