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Organization

NOVUS WYOMING A PROFESSIONAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CARRIE VAUGHAN (PRACTICE MANAGER)
(404) 419-0237
Entity
Organization

Contact information

Practice address
711 ONYX ST, KEMMERER, WY 83101-3214
(404) 419-0230
Mailing address
PO BOX 12766, PENSACOLA, FL 32591-2766

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
367500000X
Certified Registered Nurse Anesthetist

Other

Enumeration date
05/25/2021
Last updated
02/23/2022
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