Individual
CHRYSTANNE LYNN SHILLCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
831 HIGHWAY 150 SOUTH, WYOMING STATE HOSPITAL PHARMACY, EVANSTON, WY 82930
(307) 789-3464
(307) 789-3660
Mailing address
831 HIGHWAY 150 SOUTH, PO BOX 177, EVANSTON, WY 82930
(307) 789-3464
(307) 789-3660
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
12877
CO
183500000X
Pharmacist
Primary
2508
WY
183500000X
Pharmacist
56840651701
UT
Other
Enumeration date
07/19/2007
Last updated
07/19/2007
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