Individual
KELLY J BISCOMBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
625 E BROADWAY AVE, JACKSON, WY 83001-8642
(307) 733-3636
Mailing address
PO BOX 428, JACKSON, WY 83001-0428
(307) 733-3636
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
25313.1633
WY
Other
Enumeration date
06/19/2017
Last updated
01/23/2021
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