Healthcare Provider Details

I. General information

NPI: 1760318133
Provider Name (Legal Business Name): LAUREN ELIZABETH MENTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1017 S CONWELL ST
CASPER WY
82601-3906
US

IV. Provider business mailing address

1017 S CONWELL ST
CASPER WY
82601-3906
US

V. Phone/Fax

Practice location:
  • Phone: 307-577-9776
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number43889
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: