Individual
DR. DEANNA LEE LASSEGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
501 S BURMA AVE, GILLETTE, WY 82716-3426
(307) 688-1000
Mailing address
501 S BURMA AVE, GILLETTE, WY 82716-3426
(307) 688-1000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2017-01326
NC
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
11456A
WY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/22/2015
Last updated
11/21/2019
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