Healthcare Provider Details

I. General information

NPI: 1821122714
Provider Name (Legal Business Name): NATASHA SUE GALLIZZI PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 E PERSHING BLVD
CHEYENNE WY
82001-3228
US

IV. Provider business mailing address

6634 SAY KALLY RD
CHEYENNE WY
82009-5734
US

V. Phone/Fax

Practice location:
  • Phone: 307-634-1818
  • Fax:
Mailing address:
  • Phone: 307-286-4636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number2904
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2904
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: