Individual
MRS. SHELLY ANN DEGROAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
155 BIG HORN AVE, LOVELL, WY 82431-2118
(307) 254-4994
Mailing address
155 BIG HORN AVE, LOVELL, WY 82431-2118
(307) 254-4994
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171M00000X
TAXONOMY
WY
Enumeration date
06/25/2014
Last updated
06/25/2014
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