Kimberly Anne Begalla, CFNP
Individual provider Active NPI Nurse Practitioner · Evanston, WY
NPI 1174563241 · NPPES record last updated Jul 14, 2015
Key facts
- NPI
- 1174563241
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 19196.0204 (WY)
- Practice address
- 75 Yellow Creek Rd
Suite 202
Evanston, WY 82930-5235 - Phone
- (307) 789-6111
- Fax
- (307) 789-7111
- NPI assigned
- Jun 7, 2006
- 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)
- Yes
- Credentials
- Nurse Practitioner
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 19196.0204 | WY | Yes |
Addresses
Primary practice location
75 Yellow Creek Rd
Suite 202
Evanston, WY 82930-5235
Mailing address
PO Box 1382
Evanston, WY 82931-1382
Phone (307) 789-6111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 118122000 | Medicaid | WY |
Other providers in Evanston, WY
- Jennifer Beagley
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- Bear River Dental
- Bear River Surgical Clinic Inc
- Bear River Urology, LLC
- Wayne A Bell
- Bellkins Paps
- James David Benson
- Linda Benson
- Raymond Hans Benson
All providers in Evanston, WY · Nurse Practitioner in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2015. 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.