Individual
MRS. EFFIE RUTH BIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1522 E A ST, CASPER, WY 82601-2254
(307) 234-6161
Mailing address
1522 E A ST, CASPER, WY 82601-2217
(307) 234-6161
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1169184
NCCPA
—
Enumeration date
10/07/2020
Last updated
10/14/2020
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