NPI 1114569357 · live from the CMS NPI Registry
Andrea Lynn Wysong, MS, RDN
Dietitian, Registered in Cheyenne, WY. National Provider Identifier 1114569357, active.
NPI record
| NPI | 1114569357 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 2360 E Pershing Blvd, Cheyenne, WY 82001 |
| Practice phone | 307-778-7550 |
| Mailing address | 2360 E Pershing Blve, Nfs 120, Cheyenne, WY 82001 |
| Enumerated | October 9, 2019 |
| Last updated | October 9, 2019 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.