Montana Andersen
Individual provider Active NPI Community Health Worker · Laramie, WY
NPI 1922600147 · NPPES record last updated Nov 12, 2020
Key facts
- NPI
- 1922600147
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- Practice address
- 4989 N 3Rd St
Laramie, WY 82072-9548 - Phone
- (307) 745-8997
- NPI assigned
- Nov 12, 2020
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Yes |
Addresses
Primary practice location
4989 N 3Rd St
Laramie, WY 82072-9548
Mailing address
4989 N 3Rd St
Laramie, WY 82072-9548
Phone (307) 745-8997
Other providers in Laramie, WY
- Alta Vista Center for Integrative Medicine, LLC
- Marissa Alvarado
- Amber G. Sankey, LLC
- Patrick Amole
- Alexander K Andersen
- Toree Andersen
- Anna Lee Anderson
- Bernard Anderson
- Debra Mae Anderson
- Jalyn M Anderson
All providers in Laramie, WY · Community Health Worker in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2020. 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.