Doctor Name: | MS. AMY HITSHEW |
NPI Number: | 1245332337 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA C |
License Number: | MD1123075 |
Business Practice Address: | 745 Buena Vista Dr Lander, WY - 825203431 |
Business Phone Number: | 3073322941 |
Business Fax Number: | 3073321920 |
Mailing Address: | 745 Buena Vista Dr, LANDER |
State: | WY |
Postal Code: | 825203431 |
Phone Number: | 3073322941 |
Fax Number: | 3073321920 |
NPI Enumeration Date: | 09/01/2006 |
NPI Last Update Date: | 06/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | MD1123075 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |