Individual
MARY KATHERINE MCCOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
824 BONNIE BRAE ST, CASPER, WY 82601-3827
(307) 265-7552
Mailing address
824 BONNIE BRAE ST, CASPER, WY 82601-3827
(307) 265-7552
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
19497
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1227723800
NATIONAL PROVIDER IDENTIF
WY
Enumeration date
09/30/2007
Last updated
09/30/2007
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