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Organization

CHILDREN 1ST PEDIATRICS ASSOCIATES OF WYOMING, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MELISSA KNUDSON-JOHNSON MD (PHYSICIAN/OWNER)
(307) 333-3690
Entity
Organization

Contact information

Practice address
732 W COLLINS DR, CASPER, WY 82601-2327
(307) 333-6940
(888) 964-2162
Mailing address
732 W COLLINS DR, CASPER, WY 82601-2327
(307) 333-6940
(888) 964-2162

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1083704803
WY
05
1518124114
WY
Enumeration date
02/13/2023
Last updated
03/09/2023
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