Healthcare Provider Details

I. General information

NPI: 1588575302
Provider Name (Legal Business Name): LYNN ALAN HAYTH II RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N DAVID ST
CASPER WY
82601-1815
US

IV. Provider business mailing address

3341 CHUCKWAGON RD
CASPER WY
82604-5454
US

V. Phone/Fax

Practice location:
  • Phone: 307-235-8222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number44684
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: