Individual
JACQUELINE GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2360 E PERSHING BLVD, CHEYENNE, WY 82001-5356
(307) 778-7550
(307) 778-7388
Mailing address
5320 JENNY LK, CHEYENNE, WY 82009-3716
(307) 630-0701
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
6520
WY
Other
Enumeration date
08/30/2024
Last updated
08/30/2024
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