Organization
WIND RIVER OBSTETRICS AND GYNECOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYANNE A HANNANEY MD (CEO)
(307) 857-3488
Entity
Organization
Contact information
Practice address
1005 COLLEGE VIEW DR, RIVERTON, WY 82501-2266
(307) 857-5217
(307) 857-5215
Mailing address
1005 COLLEGE VIEW DR, RIVERTON, WY 82501-2289
(307) 856-4232
(307) 856-4243
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
6798A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118601900
—
WY
Enumeration date
06/06/2006
Last updated
05/31/2012
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