Individual
MRS. DEBRA JEAN SEVEREIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
34 QUARTER HORSE LN, CODY, WY 82414-8204
(307) 899-5754
Mailing address
34 QUARTER HORSE LN, CODY, WY 82414-8204
(307) 899-5754
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
3633
MT
Other
Enumeration date
04/26/2011
Last updated
04/26/2011
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