Individual provider Active NPI

Julie Lorraine Resheske, CPNP

  • Pediatric Nurse Practitioner
  • Wheatland, WY
National Provider Identifier
1104812635
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
463169703102 Issued in UT
Practice address
1551 Brice St
Wheatland, WY 82201-3505
Phone
(307) 322-3861
Fax
(307) 322-2018
NPI assigned
Sep 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 463169703102 UT Primary

Addresses

Primary practice location

1551 Brice St
Wheatland, WY 82201-3505

Mailing address

2033 Concha Loop
Cheyenne, WY 82009-1266
Phone (307) 638-8975

Other names 1

  • Julie Lorraine Resheske-Fisher Former name

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
463169703102UTMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Doc Martins Ear, Nose & Throat PastSince Aug 1, 1997 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1104812635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2033 CONCHA LOOP",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820091266",
            "telephone_number": "307-638-8975",
            "fax_number": "307-634-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 BRICE ST",
            "city": "WHEATLAND",
            "state": "WY",
            "postal_code": "822013505",
            "telephone_number": "307-322-3861",
            "fax_number": "307-322-2018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESHESKE",
        "first_name": "JULIE",
        "middle_name": "LORRAINE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "UT",
            "license": "463169703102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "RESHESKE-FISHER",
            "middle_name": "LORRAINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wheatland, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.