Individual
AMY MARIE GRUWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1900 E 1ST ST, CASPER, WY 82601-2747
(307) 577-7737
(307) 577-0049
Mailing address
1900 E 1ST ST, CASPER, WY 82601-2747
(307) 577-7737
(307) 577-0049
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
19507.318
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120223500
—
WY
01
—
315275
BC/BS
WY
01
—
611665901
DEPT OF LABOR
WY
Enumeration date
09/26/2005
Last updated
05/09/2012
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