Individual
MRS. ERIN HETLAND MISCHKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
777 AVENUE H, POWELL, WY 82435-2260
(307) 754-2267
Mailing address
777 AVENUE H, POWELL, WY 82435-2260
(307) 754-2267
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
509
WY
363A00000X
Physician Assistant
Primary
TC908
KY
363AM0700X
Medical Physician Assistant
TL509
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TL509
WY STATE LICENSE
WY
Enumeration date
12/30/2010
Last updated
05/29/2024
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