Nancy Ann Axthelm, CCCSLP
Individual provider Active NPI Speech-Language Pathologist · Cody, WY
NPI 1104019850 · NPPES record last updated Aug 24, 2007
Key facts
- NPI
- 1104019850
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SP158 (WY)
- Practice address
- 808 North Street
Cody, WY 82414-5213 - Phone
- (307) 527-7060
- Fax
- (307) 587-2497
- NPI assigned
- Aug 24, 2007
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP158 | WY | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP158 | WY | Yes |
Addresses
Primary practice location
808 North Street
Cody, WY 82414-5213
Mailing address
PO Box 2901
Cody, WY 82414-5213
Phone (307) 527-7060
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770688871 | Medicaid | WY |
Other names
- Nancy Walters
Other providers in Cody, WY
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- Brittany Asay
- Levi Asay
- Aspen Counseling Services LLC
- Lucinda Marie Atnip
- Hans Ayres
- Shaun Robin Balch
- Valerie J Baldes
- Demetria Bales
- Kristen Dewar Bancroft
All providers in Cody, WY · Speech-Language Pathologist 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 24, 2007. 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.