Individual
ROLAND MALDONADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
258 NTH HAYES STREET, LARAMIE, WY 82070
(303) 242-1661
Mailing address
258 NTH HAYES STREET, LARAMIE, WY 82070
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
16080
WY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
48594
WY
Other
Enumeration date
09/10/2020
Last updated
11/23/2021
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