Healthcare Provider Details

I. General information

NPI: 1386914273
Provider Name (Legal Business Name): BONNIE JUST PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BONNIE NELSON RN

II. Dates (important events)

Enumeration Date: 01/09/2012
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E 20TH ST STE 200
CHEYENNE WY
82001-3880
US

IV. Provider business mailing address

PO BOX 20970
CHEYENNE WY
82003-7020
US

V. Phone/Fax

Practice location:
  • Phone: 307-633-7444
  • Fax:
Mailing address:
  • Phone: 307-996-4777
  • Fax: 307-773-8013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number29472
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number57131
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: