PLATTE RIVER FAMILY PRACTICE LLC NPI 1942443536

NPI Information

NPI: 1942443536
Provider Name: PLATTE RIVER FAMILY PRACTICE LLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 53D1099140

Address:
1900 E 1ST ST
CASPER, WY
ZIP 82601
Phone: (307) 577-7737
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PLATTE RIVER FAMILY PRACTICE LLC is a family nurse practitioner in Casper, WY. PLATTE RIVER FAMILY PRACTICE LLC NPI is 1942443536. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1900 E 1ST ST
CASPER, WY
ZIP 82601-747
Phone: (307) 577-7737
Fax: (307) 577-0049

The provider's authorized official is Amy Marie Gruwell .
The authorized official title is President/owner and has the following contact phone number (307) 577-7737.

The CLIA number assigned to this NPI record is 53D1099140 - practitioner other with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 4/12/2009 and was last updated on 5/17/2012.

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	19507.318	WYOMING	Yes

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	W22584	MEDICARE OSCAR/CERTIFICATION	WYOMING
2	128539400	MEDICAID	WYOMING

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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