MISS KELLY LYNNE PRETTY WEASEL (NPI# 1770898140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770898140 |
| Entity Type | Individual |
| Full Name | MISS KELLY LYNNE PRETTY WEASEL |
| Credential | RN |
| Practice Address |
29 Blackcole Dr Fort Washakie WY 82514 |
| Mailing Address |
Po Box 128 Fort Washakie WY 82514-0128 |
| Practice Telephone | 3073327300 |
| Mailing Telephone | 3073327300 |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2010-08-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP0904X |
Clinic/Center Specialization: Public Health, Federal |
Ambulatory Health Care Facilities |
| Street Address |
29 BLACKCOLE DR |
| City | FORT WASHAKIE |
| State | WY |
| Zip Code | 82514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619527819 | Melissa Rose Pine | Registered Nurse | 29 Blackcole Road, Fort Washakie, WY 82514 | 2019-09-19 |
| 1982116794 | Madonna Lee Kienlen | Peer Specialist | 215 Ethete Road, Ft. Washakie, WY 82514 | 2017-11-02 |
| 1649789025 | Rebecca Charlene Willis | Technician, Other | Fort Washakie Healt Center Lab Ihs 29 Black Coal Drive, Fort Washakie, WY 82514 | 2017-09-28 |
| 1033553185 | Pauline Elizabeth Powers-peprah | Family Medicine | 29 Black Cole, Fort Washakie, WY 82514 | 2013-04-19 |
| 1528319373 | Amanda L Schultz | Licensed Practical Nurse | 110 Sharpnose Road, Fort Washakie, WY 82514 | 2012-09-19 |
| 1285950170 | Debra Kay Waters | Technician, Pathology | Black Coal Rd. Bldg. 29, Ft. Washakie, WY 82514 | 2010-04-16 |
| 1881919751 | Shoshone & Arapaho Tribal Substance Abuse Court | Clinic/Center | 215 Ethete Rd, Fort Washakie, WY 82514 | 2010-04-02 |
| 1770814253 | Christopher G Nelson | Spec/Tech, Pathology | 29 Black Coal Rd, Ft. Washakie, WY 82514 | 2010-01-22 |
| 1922339449 | Nina Williams | Spec/Tech, Pathology | Black Coal Rd Bldg 29, Ft Washakie, WY 82514 | 2010-01-22 |
| 1821329459 | Karen Fay Gibson | Clinical Medical Laboratory | 29 Blackcoal Dr., Laboratory, Fort Washakie, WY 82514 | 2010-01-21 |
| Find all providers in zip 82514 | ||||
| Taxonomy Code | 261QP0904X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Public Health, Federal |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023174299 | Us Health Dept of Health & Human Services | Clinic/Center | Black Coal Drive, #29, Fort Washakie, WY 82514-0128 | 2006-12-29 |
| 1922320910 | Phs Indian Health Service | Clinic/Center | 29 Black Coal Drive, Fort Washakie, WY 82514-0128 | 2010-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104976372 | Us Health Dept of Health & Human Services | Clinic/Center | 14 Great Plains Road, Arapahoe, WY 82501 | 2007-01-11 |
| City | FORT WASHAKIE |
| Zip Code | 82514 |
Please comment or provide details below to improve the information on MISS KELLY LYNNE PRETTY WEASEL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.