Individual
JESSE HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1252 N 22ND ST UNIT B, LARAMIE, WY 82072-5306
(307) 745-3704
Mailing address
1252 N 22ND ST UNIT B, LARAMIE, WY 82072-5306
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
23263.1005
WY
Other
Enumeration date
06/12/2009
Last updated
07/19/2009
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