Shea Lehnen

Individual provider Active NPI Community Health Worker · Douglas, WY

NPI 1366802431 · NPPES record last updated Mar 2, 2016

Key facts

NPI
1366802431
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
Practice address
1841 Madora Ave
Douglas, WY 82633-3057
Phone
(307) 358-2846
Fax
(307) 358-1144
NPI assigned
Mar 2, 2016
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)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X WY Yes

Addresses

Primary practice location

1841 Madora Ave
Douglas, WY 82633-3057

Mailing address

1841 Madora Ave
Douglas, WY 82633-3057
Phone (307) 358-2846

Other identifiers

IdentifierTypeStateIssuer
106402908MedicaidWY
106402907MedicaidWY

Other providers in Douglas, WY

All providers in Douglas, WY · Community Health Worker in Wyoming

Sources for this page

Verify at the official NPI Registry.