Individual
MS. J'LAINE PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC, PMHNP-BC
Contact information
Practice address
1465 N 4TH ST, SUITE #119, LARAMIE, WY 82072-2066
(307) 721-0700
(307) 721-1039
Mailing address
1465 N 4TH ST, SUITE 119, LARAMIE, WY 82072-2066
(307) 721-0700
(307) 721-1039
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
199070282
WY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
19907.0282
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120576500
—
WY
Enumeration date
08/12/2006
Last updated
10/22/2011
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