Healthcare Provider Details

I. General information

NPI: 1932471133
Provider Name (Legal Business Name): JILL E. GIRANY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2012
Last Update Date: 02/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4003 RAWLINS ST
CHEYENNE WA
82001
US

IV. Provider business mailing address

4003 RAWLINS ST..
CHEYENNE WY
82001-1800
US

V. Phone/Fax

Practice location:
  • Phone: 307-638-8975
  • Fax:
Mailing address:
  • Phone: 307-638-8975
  • Fax: 307-634-9267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number23275.1142
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: