Individual
KATHLEEN VANIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
625 E BROADWAY AVE BLDG B, JACKSON, WY 83001-8642
(307) 739-7450
(307) 739-7344
Mailing address
PO BOX 428, JACKSON, WY 83001-0428
(307) 733-3636
(307) 739-7344
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13781A
WY
207R00000X
Internal Medicine Physician
A77195
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2122987000
—
WY
Enumeration date
07/10/2006
Last updated
02/01/2022
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