Individual
DR. NILS CHARLES WESTFALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
555 E BROADWAY AVE STE 204, JACKSON, WY 83001-8640
(307) 739-4818
(307) 739-4866
Mailing address
PO BOX 428, JACKSON, WY 83001-0428
(307) 739-4818
(307) 739-4866
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
13186A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156592300
—
WY
Enumeration date
03/21/2013
Last updated
02/19/2021
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