MEDICARE: PAULA MARIE THORNTON NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	1236	WY
2	363LA2200X	Adult Health Nurse Practitioner	1236	WY
3	363LG0600X	Gerontology Nurse Practitioner	1236	WY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083624266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA MARIE THORNTON NP

Provider Business Mailing Address
First Line	:	PO BOX 20970
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82003-7020
Country	:	US
Telephone Number	:	307-634-2273
Fax Number	:

Provider Business Practice Location Address
First Line	:	2301 HOUSE AVE STE 201
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82001-3177
Country	:	US
Telephone Number	:	307-638-7757
Fax Number	:	307-638-8359

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	11/18/2025

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