Organization
INTEGRATIVE HEALTHCARE SERVICES OF WYOMING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA JEAN THRELKELD APRN (APRN/OWNER)
(307) 554-0522
Entity
Organization
Contact information
Practice address
1300 E A ST STE 201, CASPER, WY 82601-2252
(307) 235-3333
Mailing address
1030 DONEGAL ST, CASPER, WY 82609-3221
(307) 554-0522
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143563900
—
WY
Enumeration date
07/18/2018
Last updated
07/18/2018
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