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Individual

KIM E CLEMETSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
29 BLACK COAL DR, FORT WASHAKIE, WY 82514
(307) 332-7300
(307) 332-7464
Mailing address
653 BURMA RD, RIVERTON, WY 82501-9763
(307) 856-2112

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
12788
WY

Other

Enumeration date
07/17/2008
Last updated
07/17/2008
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