Nichole L Duff

Individual provider Active NPI Community Health Worker · Gillette, WY

NPI 1801627005 · NPPES record last updated Aug 9, 2024

Key facts

NPI
1801627005
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
Practice address
812 E 4TH St
Gillette, WY 82716-4033
Phone
(307) 257-7180
Fax
(307) 257-7183
NPI assigned
Aug 9, 2024
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 Yes

Addresses

Primary practice location

812 E 4TH St
Gillette, WY 82716-4033

Mailing address

812 E 4TH St
Gillette, WY 82716-4033
Phone (307) 257-7180

Other providers in Gillette, WY

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

Sources for this page

Verify at the official NPI Registry.