Individual
SHAWNA FIFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
929 BIG HORN DR, RIVERTON, WY 82501-2513
(307) 850-2635
Mailing address
929 BIG HORN DR, RIVERTON, WY 82501-2513
(307) 850-2635
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
129678700
PROVIDER
WY
Enumeration date
11/06/2014
Last updated
11/06/2014
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