HEALTHY LIFESTYLE MEDICINE NPI 1912478819

NPI Information

HEALTHY LIFESTYLE MEDICINE is an adult medicine family medicine in Cheyenne, WY. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. HEALTHY LIFESTYLE MEDICINE NPI is 1912478819. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6015 SYCAMORE RD
CHEYENNE, WY
ZIP 82009-347
Phone: (307) 823-2968

The provider's authorized official is Kristine Van Kirk .
The authorized official title is Owner/provider and has the following contact phone number (307) 823-2968.

The CLIA number assigned to this NPI record is 53D2161117 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/17/2018 and was last updated on 12/20/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.