Cheyenne Children'S Clinic, PC
Organization Active NPI Pediatrics Physician · Cheyenne, WY
NPI 1073537601 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1073537601
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- Legal business name
- CHEYENNE CHILDREN'S CLINIC, PC
- Practice address
- 2301 House Ave
Suite 405
Cheyenne, WY 82001-3176 - Phone
- (307) 635-7961
- Fax
- (307) 778-5812
- NPI assigned
- Jul 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Robin Theobald
- Title
- Clinic Administrator
- Phone
- (307) 635-7961
Practitioners 94
-
Briana Michele Bailey, APRN, FNP-C
-
Nathaniel Mason Beaty, PA-C
-
Thomas James Bledsoe, M.P.T.
-
Caleb Brackett, MD
-
Lisa K Burton, MD
-
Tracie Caller, M.D.
-
Shannon Lynn Cook, DNP, FNP-C
-
William Denk, MD
-
Isheeka Edwards, MD
-
Jennifer Favilla, FNP
-
Kelly Ginger Follett, M.D.
-
Molly Fretag, OTD
-
Brian B Friis, D.P.M.
-
Daulton K. Grube, MD
-
Amy J Harnish, MD
-
Hali Harrison, MS, RD, LD
-
Joanne Laura Hassell, M.D.
National Provider Directory
Locations
2301 House Ave
Ste 201
Cheyenne, WY 82001
Phone (307) 635-9131
214 E 23rd St
Bldg 214
Cheyenne, WY 82001
2301 House Ave
Ste 405
Cheyenne, WY 82001
Phone (307) 635-7961
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | Yes |
Addresses
Primary practice location
2301 House Ave
Suite 405
Cheyenne, WY 82001-3176
Mailing address
2301 House Ave
Suite 405
Cheyenne, WY 82001-3176
Phone (307) 635-7961
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All providers in Cheyenne, WY · Pediatrics Physician in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.