Jolynn Renee Davis, R.N.

Individual provider Active NPI Registered Nurse · Fort Washakie, WY

NPI 1043481211 · NPPES record last updated Mar 17, 2008

Key facts

NPI
1043481211
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
11208 (WY)
Practice address
29 Black Coal Drive
Fort Washakie, WY 82514
Phone
(307) 335-5963
Fax
(307) 332-7464
NPI assigned
Mar 17, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
11208WYMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 11208 WY Yes

Addresses

Primary practice location

29 Black Coal Drive
Fort Washakie, WY 82514

Mailing address

1010 S 3Rd St
Lander, WY 82520-3908
Phone (307) 332-2569

Other providers in Fort Washakie, WY

All providers in Fort Washakie, WY · Registered Nurse in Wyoming

Sources for this page

Verify at the official NPI Registry.