Organization
EQUALITY STATE INFECTION FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA WILLETTE (MANAGER)
(307) 234-8700
Entity
Organization
Contact information
Practice address
5810 E 2ND ST, SUITE 200, CASPER, WY 82609-4329
(307) 234-8700
(307) 234-8750
Mailing address
5810 E 2ND ST, SUITE 200, CASPER, WY 82609-4329
(307) 234-8700
(307) 234-8750
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
—
—
207RI0200X
Infectious Disease Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
03/24/2008
Last updated
03/24/2008
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