ANTELOPE MEDICAL CONSULTANTS LLC NPI 1124188545

NPI Information

NPI: 1124188545
Provider Name: ANTELOPE MEDICAL CONSULTANTS LLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
430 S MEDICAL ARTS CT
GILLETTE, WY
ZIP 82716
Phone: (307) 682-7661
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ANTELOPE MEDICAL CONSULTANTS LLC is a family nurse practitioner in Gillette, WY. ANTELOPE MEDICAL CONSULTANTS LLC NPI is 1124188545. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

430 S MEDICAL ARTS CT
GILLETTE, WY
ZIP 82716-364
Phone: (307) 682-7661
Fax: (307) 682-5074

The provider's authorized official is Lisa Anne Malody .
The authorized official title is Owner and has the following contact phone number (307) 682-7661.

The enumeration date for this NPI number is 12/8/2006 and was last updated on 8/22/2020.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	18882.269	WYOMING	Yes
2	207R00000X	Internal Medicine		5806A	WYOMING	X
3	207RC0000X	Internal Medicine	Cardiovascular Disease	5853A	WYOMING	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00783001	OTHER	WYOMING	BLUE CROSS CLINIC NUMBER
2	7088727	MEDICAID	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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