Individual
MRS. KRISTINA MARIE HERNANDEZ MCDOUGALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
151 W. BRUNDAGE ST., SHERIDAN, WY 82801
(307) 674-1668
Mailing address
493 BROOK ST, PO BOX 166, RANCHESTER, WY 82839
(307) 683-6414
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1740318013
NPI#
WY
Enumeration date
06/06/2012
Last updated
06/06/2012
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