Individual
MR. JED CABRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
820 EAST 17TH STREET, CHEYENNE, WY 82001-4797
(307) 632-2434
(307) 634-9295
Mailing address
820 EAST 17TH STREET, CHEYENNE, WY 82001-4797
(307) 777-7911
(307) 638-3616
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
375
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24512
WINHEALTH
WY
Enumeration date
09/20/2006
Last updated
07/08/2007
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