4JS LLC
Organization Active NPI Registered Nurse First Assistant · Jackson, WY
NPI 1144732736 · NPPES record last updated Oct 17, 2018
Key facts
- NPI
- 1144732736
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Registered Nurse First Assistant 163WR0006X
- License
- 30955 (WY)
- Legal business name
- 4JS LLC
- Practice address
- 625 E Broadway Ave
Jackson, WY 83001-8642 - Phone
- (307) 733-2443
- Fax
- (307) 733-6912
- NPI assigned
- Nov 3, 2017
- Organization subpart
- No
Authorized official
- Name
- Justin Tattersall
- Title
- President
- Phone
- (307) 413-0437
Practitioners 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse First Assistant |
163WR0006X | 30955 | WY | Yes |
Addresses
Primary practice location
625 E Broadway Ave
Jackson, WY 83001-8642
Mailing address
PO Box 9871
Jackson, WY 83002-9871
Other practice location 1
7170 N Rachel Way
Jackson, WY 83001-8039
Phone (307) 413-0437
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30955 | Other | NURSING |
Other providers in Jackson, WY
- 1918 Winter Street Operating Co LLC
- A Francine Tryka MD PC
- Rogina Adkins
- Advanced Dermatology of Wyoming, Inc
- Albertsons LLC
- Charlotte Hale Alexander
All providers in Jackson, WY · Registered Nurse First Assistant in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2018. 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.