Kelli Hansen, LAT, ATC
Individual provider Active NPI Athletic Trainer · Afton, WY
NPI 1013572874 · NPPES record last updated May 7, 2019
Key facts
- NPI
- 1013572874
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 115 (WY)
- Practice address
- 901 Adams St
Afton, WY 83110-9621 - Phone
- (307) 885-5800
- NPI assigned
- May 7, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 115 | WY | Yes |
Addresses
Primary practice location
901 Adams St
Afton, WY 83110-9621
Mailing address
PO Box 1482
Afton, WY 83110-1482
Phone (208) 850-9039
Other providers in Afton, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.