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Individual

MS. LAURA A GERVAIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGPCNP-BC

Contact information

Practice address
2360 E PERSHING BLVD, CHEYENNE, WY 82001-5356
(307) 365-4671
Mailing address
2360 E PERSHING BLVD, CHEYENNE, WY 82001-5356
(307) 365-4671

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
610
WY
163WG0600X
Gerontology Registered Nurse
1665376
CO
363LP2300X
Primary Care Nurse Practitioner
Primary
31031-1594
WY

Other

Enumeration date
10/23/2006
Last updated
12/12/2019
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