NPI 1104062314 · live from the CMS NPI Registry
Equality State Infection Foundation
Internal Medicine, Infectious Disease in Casper, WY. National Provider Identifier 1104062314, active.
NPI record
| NPI | 1104062314 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine, Infectious Disease 207RI0200X |
| Practice location | 5810 E 2nd St Ste 200, Casper, WY 82609 |
| Practice phone | 307-234-8710 |
| Enumerated | December 18, 2008 |
| Last updated | December 18, 2008 |
| Authorized official | Lisa Willette, Coo, Cfo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered | 133V00000X | — |
| Registered Nurse, Case Management | 163WC0400X | — |
| Counselor | 101Y00000X | — |
| Early Intervention Provider Agency | 252Y00000X | — |
| Internal Medicine, Infectious Disease primary | 207RI0200X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.