Organization Name: | WIND RIVER SERVICE UNIT IHS |
NPI Number: | 1326206616 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TRINA RENE' NATION (NURSE SPECIALIST) |
Mailing Address: | 29 Black Coal Dr Fort Washakie |
State: | WY US |
Postal Code: | 825140000 |
Phone Number: | 3073327300 |
Fax Number: | 3073329446 |
NPI Enumeration Date: | 05/23/2008 |
NPI Last Update Date: | 05/23/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | 9336 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |