Healthcare Provider Details

I. General information

NPI: 1003821455
Provider Name (Legal Business Name): CATHERINE LOUISE TEASLEY R.N. BSN,MSNI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 09/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7604 RIDGE RD
CHEYENNE WY
82009
US

IV. Provider business mailing address

2360 E PERSHING BLVD
CHEYENNE WY
82001-5356
US

V. Phone/Fax

Practice location:
  • Phone: 307-256-7605
  • Fax:
Mailing address:
  • Phone: 307-778-7550
  • Fax: 307-778-7599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number13666
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: