Organization
SUNLIGHT PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTA L BLOUGH APRN (PSYCHIATRIC MENTAL HEALTH NURSE PRA)
(307) 764-4130
Entity
Organization
Contact information
Practice address
145 N BERNARD ST, POWELL, WY 82435-2617
(307) 764-4130
Mailing address
145 N BERNARD ST, POWELL, WY 82435-2617
(307) 764-4130
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
19373.1191
WY
Other
Enumeration date
10/12/2012
Last updated
05/16/2013
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