Kelly Lynne Pretty Weasel, RN

Primary specialty

Federal Public Health Clinic/CenterTaxonomy code 261QP0904X

Practice address

29 Blackcole Dr
Fort Washakie, WY 82514

Phone

(307) 332-7300

NPI assigned

Aug 10, 2010

Last updated

Aug 10, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

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

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281398400000",
    "number": "1770898140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 128",
            "city": "FORT WASHAKIE",
            "state": "WY",
            "postal_code": "825140128",
            "telephone_number": "307-332-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 BLACKCOLE DR",
            "city": "FORT WASHAKIE",
            "state": "WY",
            "postal_code": "82514",
            "telephone_number": "307-332-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRETTY WEASEL",
        "first_name": "KELLY",
        "middle_name": "LYNNE",
        "name_prefix": "Miss",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-10",
        "last_updated": "2010-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP0904X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, Federal",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clariza C Pascual, DMD, RDH
• PHS Indian Health Service
• Melissa Rose Pine, RN
• Daniel Lee Plaisted, PHARM.D.
• Pauline Elizabeth Powers-Peprah, DO
• Garth Ernest Reber, D.O.
• Phillip Kent Rector, PHD
• Janice C Roman, R.N.
• Beth Schulte
• Amanda L Schultz, LPN

• Clinic/Center in Fort Washakie, WY
• Providers in Fort Washakie, WY by specialty
• Clinic/Center in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; 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.