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Individual

MS. TIA JEAN HANSULD (WELCH)

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
680 E 18TH ST, CASPER, WY 82601-4703
(307) 259-6870
(307) 237-2036
Mailing address
680 E 18TH ST, CASPER, WY 82601-1759
(307) 237-7569
(307) 237-2036

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
9090.162
WY

Other

Enumeration date
10/13/2006
Last updated
01/08/2015
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