Healthcare Provider Details

I. General information

NPI: 1821251067
Provider Name (Legal Business Name): DONNA NURSS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 07/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 N ASH ST STE. 102
CASPER WY
82601-1821
US

IV. Provider business mailing address

130 N ASH ST STE. 102
CASPER WY
82601-1821
US

V. Phone/Fax

Practice location:
  • Phone: 307-235-3333
  • Fax: 307-266-5155
Mailing address:
  • Phone: 307-235-3333
  • Fax: 307-266-5155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number13302.248
License Number StateWY

VIII. Authorized Official

Name: DONNA M NURSS
Title or Position: PRESIDENT
Credential: A.P.R.N.
Phone: 307-235-3333