Organization
PLATTE RIVER FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY MARIE GRUWELL FNPC (PRESIDENT/OWNER)
(307) 577-7737
Entity
Organization
Contact information
Practice address
1900 E 1ST ST, CASPER, WY 82601-2747
(307) 577-7737
(307) 577-0049
Mailing address
1900 E 1ST ST, CASPER, WY 82601-2747
(307) 577-7737
(307) 577-0049
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19507.318
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128539400
—
WY
Enumeration date
04/12/2009
Last updated
05/17/2012
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