NPI 1346336500 · live from the CMS NPI Registry
Joanie Marie Deatrich, DO
Family Medicine, Adult Medicine in Cheyenne, WY. National Provider Identifier 1346336500, active.
NPI record
| NPI | 1346336500 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine, Adult Medicine 207QA0505X |
| Practice location | 2360 E Pershing Blvd, Cheyenne, WY 82001 |
| Practice phone | 307-778-7555 |
| Mailing address | 2818 Cherrystone Pl, Fort Collins, CO 80525 |
| Enumerated | October 5, 2006 |
| Last updated | October 1, 2020 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine, Adult Medicine primary | 207QA0505X | 0055774 (CO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.