Kristen Dewar Bancroft

Individual provider Active NPI Community Health Worker · Cody, WY

NPI 1477817583 · NPPES record last updated Jul 3, 2012

Key facts

NPI
1477817583
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
Practice address
2713 Cougar Ave
Cody, WY 82414-8400
Phone
(307) 587-5112
Fax
(307) 587-5446
NPI assigned
Jul 3, 2012
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Yes

Addresses

Primary practice location

2713 Cougar Ave
Cody, WY 82414-8400

Mailing address

2538 Big Horn Ave
Cody, WY 82414-9299
Phone (307) 587-2197

Other names

  • Ms. Kris Bancroft Other name

Other providers in Cody, WY

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

Sources for this page

Verify at the official NPI Registry.