Healthcare Provider Details

I. General information

NPI: 1891659652
Provider Name (Legal Business Name): HALLE REESE NESSLAND RDCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2360 E PERSHING BLVD # 111B
CHEYENNE WY
82001-5356
US

IV. Provider business mailing address

2360 E PERSHING BLVD # 111B
CHEYENNE WY
82001-5356
US

V. Phone/Fax

Practice location:
  • Phone: 307-778-7550
  • Fax: 307-778-7501
Mailing address:
  • Phone: 307-778-7550
  • Fax: 307-778-7501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: